Study of Effect of Zinc Sulphate On Improving The Clinical Symptoms of Pneumonia In Paediatric Population

Abstract

Background: Pneumonia is one of the common mortality causes in young children. Some studies have shown beneficial effect of zinc supplements on treatment of pneumonia. The aim of the present study was to examine the effect of zinc sulphate on improving the clinical symptoms of pneumonia in 2-59- month-old children.  Materials and methods: A clinical study was conducted in the Department of Paediatrics VIMS, Pawapuri, Nalanda, Bihar, India fromOctober 2019 to February 2020. The children with pneumonia were randomly assigned into intervention (n=50), and control (n=50) groups. The control group received placebo. The intervention group received zinc sulphate as 10 mg/day in children younger than one, and 20 mg/day in children above one year-old every 12 hours (during hospitalization). During hospitalization, every 12 hours the clinical symptoms of both groups including  tachypnea (number of breaths), coughs, fever, intercostal retraction, hypoxia, crackles, wheezing, lethargy, and duration of hospitalization were evaluated. In both groups, at the beginning and end of hospitalization, Blood sample was taken for the necessary tests and for determining the serum level of zinc through the brachial vein and sent to laboratory.  Results: In this study 100 patients were include. Out of 100, 50 patients were included to the intervention and 50 to the control groups. The gender distribution of the tested patients was 52% boys and 48% girls. There was no significant difference between the two groups in terms of age, gender, and weight. The mean age of the hospitalized patients was13.25+0.685, with the minimum andmaximum of 2 and 59 months-old, respectively. The mean age in the intervention group was 14.36+0.784 and in the control it was 12.12+0.685 (p>0.05). The mean age of hospitalization in the case and control groups was 14.31+0.765 and 12.55+0.841 months, respectively, which was not statistically significant (p=0.498). The mean duration of hospitalization was 5.66+0.545, with the minimum and maximum of 2 and 12 days respectively. The mean duration of hospitalization cases and control groups was 5.8+0.284 and 5.14+0.294 days respectively; based on the Mann-Whitney test, there was no significant difference between the two groups (p=0.165). The serum level of zinc was calculated at the beginning of hospitalization and at the time of discharge for both intervention and control groups. The mean serum level of zinc in the intervention group (receiving zinc sulphate syrup) was 69.89(11.8) and 94.8(12.3) mcg/dl at the baseline and at the end of hospitalization respectively (p<0.001); while the mean serum level of zinc in the control group (receiving placebo) was 71.3(10.3)and 71.9(10.2)mcg/dl at the beginning and end of hospitalization respectively (p=0.47).There was no significant difference between the two groups when comparing the presence or absence of tachypnea during hospitalization, as well as 12 and 24 hours post-hospitalization. However, at 36 hours post-hospitalization, there was a significant difference (p=0.01).  Conclusion: Zinc sulphate supplement be considered for pediatric patients hospitalized due to pneumonia, in addition to the standard and conventional pharmacotherapy of pneumonia.

Keywords: Pneumonia, zinc, supplementation, treatment.