The Role of Zinc in Pediatric Respiratory Infections: Evidence from Clinical Trials and Real-World Studies
Giulio Dinardo1, Cristiana Indolfi1, Angela Klain1
1Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80138 Naples, Italy.
Insights
Zinc supplementation may help prevent pediatric respiratory infections, especially in deficient children. While beneficial for prevention, its role in treating acute infections is less clear, requiring further research.
Area of Science:
- Immunology
- Nutritional Science
- Pediatrics
Background:
- Zinc is crucial for immune function and preventing infections, particularly in children.
- Zinc deficiency increases susceptibility to pediatric infections.
Purpose of the Study:
- To review evidence on zinc's role in preventing and managing pediatric respiratory infections.
- To assess zinc monotherapy and multicomponent supplements.
Main Methods:
- Comprehensive literature review of RCTs, real-world studies, and guidelines.
- Inclusion of zinc monotherapy and multicomponent supplements.
Main Results:
- Zinc supplementation shows a preventive role in reducing respiratory infection incidence and burden, especially in recurrent cases and deficient populations.
- Multicomponent supplements with zinc improved infection frequency, duration, and outcomes with good safety.
- Data on zinc for acute infection treatment, particularly severe pneumonia, are inconsistent.
Conclusions:
- Zinc is valuable for preventive immune-nutritional strategies in pediatric respiratory infections, particularly in multicomponent formulations and long-term use.
- Optimizing zinc status may reduce infection recurrence and disease burden.
- Further trials are needed to define optimal dosing, timing, and target groups for zinc interventions.
Abstract:
Background/Objectives: Zinc is an essential trace element involved in multiple aspects of immune function, including epithelial barrier integrity, innate and adaptive immune responses, regulation of inflammation and oxidative stress. Zinc deficiency has been associated with increased susceptibility to infections, particularly in the pediatric population. This narrative review aims to summarize and discuss current evidence on the role of zinc in the prevention and management of pediatric respiratory infections. Methods: A comprehensive literature review was conducted including randomized controlled trials, real-world studies, and international guidelines published in recent years. Both zinc monotherapy and multicomponent dietary supplements containing zinc were considered. Results: Evidence consistently supports a preventive role of zinc supplementation in reducing the incidence and burden of respiratory infections, particularly in children with recurrent disease and in zinc-deficient populations. Zinc-containing multicomponent supplements demonstrated significant reductions in infection frequency and duration, alongside improved patient and parent-reported outcomes, with a favorable safety profile. In contrast, data on zinc as an adjunctive treatment during acute infections, especially severe pneumonia, are less consistent, with limited impact on major clinical outcomes. The effectiveness of zinc appears to be influenced by treatment duration, baseline nutritional status, and formulation. Conclusions: In conclusion, zinc may represent a valuable component of preventive immune-nutritional strategies for pediatric respiratory infections, especially when administered as part of multicomponent formulations and over prolonged periods. While its role in acute disease management remains uncertain, optimizing zinc status may contribute to reducing infection recurrence and overall disease burden. Further well-designed trials are warranted to clarify optimal dosing, timing, and target populations.
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