Question 1: Use the following study (link here) to answer the following questions below: What are the independent and dependent variables of the study? b) Is this study experimental or observational? How can you tell?c) Is this study quantitative or qualitative? How can you tell?d) One of the primary end points/outcomes the study listed was the number of days that it took to reach a 50% reduction in symptoms as reported on a 12-Symptom scale. In Table 2, you can see that the statistical test they used to evaluate differences between groups for this end point produced a p-value of 0.97. Please provide an interpretation of this p-value, explaining what it means in terms of whether significant differences exist between the groups in the number of days it took to achieve a 50% reduction in symptoms on the 12-Symptom scale. JAMANetwork Open.Original Investigation | Public HealthEffect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Careon Symptom Length and Reduction Among Ambulatory PatientsWith SARS-CoV-2 InfectionThe COVID A to Z Randomized Clinical TrialSuma Thomas, MD, MBA; Divyang Patel, MD, MS; Barbara Bittel, BSN, RN; Kathy Wolski, MPH; Qiuqing Wang, MS; Anirudh Kumar, MD, MS; Zachary J. Il'Giovine, MD;Reena Mehra, MD, MS; Carla McWilliams, MD; Steve E. Nissen, MD; Milind Y. Desai, MD, MBAAbstractIMPORTANCE There is limited evidence regarding early treatment of novel severe acute respiratorysyndrome coronavirus 2 (SARS-CoV-2) infection to mitigate symptom progression.OBJECTIVE To examine whether high-dose zinc and/or high-dose ascorbic acid reduce the severityor duration of symptoms compared with usual care among ambulatory patients with SARS-CoV-2infection.DESIGN, SETTING, AND PARTICIPANTS This multicenter, single health system randomized clinicalfactorial open-label trial enrolled 214 adult patients with a diagnosis of SARS-CoV-2 infectionconfirmed with a polymerase chain reaction assay who received outpatient care in sites in Ohio andFlorida. The trial was conducted from April 27, 2020, to October 14, 2020.INTERVENTION Patients were randomized in a 1:1:1:1 allocation ratio to receive either 10 days of zincgluconate (50 mg), ascorbic acid (8000 mg), both agents, or standard of care.OUTCOMES The primary end point was the number of days required to reach a 50% reduction insymptoms, including severity of fever, cough, shortness of breath, and fatigue (rated on a 4-pointscale for each symptom). Secondary end points included days required to reach a total symptomseverity score of O, cumulative severity score at day 5, hospitalizations, deaths, adjunctive prescribedmedications, and adverse effects of the study supplements.RESULTS A total of 214 patients were randomized, with a mean (SD) age of 45.2 (14.6) years and 132(61.7%) women. The study was stopped for a low conditional power for benefit with no significantdifference among the 4 groups for the primary end point. Patients who received usual care withoutsupplementation achieved a 50% reduction in symptoms at a mean (SD) of 6.7 (4.4) days comparedwith 5.5 (3.7) days for the ascorbic acid group, 5.9 (4.9) days for the zinc gluconate group, and 5.5(3.4) days for the group receiving both (overall P = .45). There was no significant difference insecondary outcomes among the treatment groups.CONCLUSIONS AND RELEVANCE In this randomized clinical trial of ambulatory patients diagnosedwith SARS-CoV-2 infection, treatment with high-dose zinc gluconate, ascorbic acid, or a combinationof the 2 supplements did not significantly decrease the duration of symptoms compared withstandard of care.TRIAL REGISTRATION Clinical Trials.gov Identifier: NCT04342728JAMA Network Open. 2021;4(2):e210369. doi:10.1001/jamanetworkopen.2021.0369Open Access. This is an open access article distributed under the terms of the CC-BY License.JAMA Network Open. 2021;4(2):e210369. doi:10.1001/jamanetworkopen.2021.0369Downloaded From: https://jamanetwork.com/ by a Samford University Library User on 03/13/2023Key PointsQuestion Do high-dose zinc, high-doseascorbic acid, and/or a combination ofthe 2 reduce the duration of symptomsof severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2)?COFindings In this randomized clinical trialof 214 patients with confirmed SARS-CoV-2 infection receiving outpatientcare, there was no significant differencein the duration of symptoms among the4 groups.Meaning These findings suggest thattreatment with zinc, ascorbic acid, orboth does not affect SARS-CoV-2symptoms.+ Visual Abstract+ Invited Commentary+ Supplemental contentAuthor affiliations and article information arelisted at the end of this article.February 12, 2021 1/10

Question

Question 1: Use the following study (link here) to answer the following questions below: What are the independent and dependent variables of the study?  b) Is this study experimental or observational? How can you tell?c) Is this study quantitative or qualitative? How can you tell?d) One of the primary end points/outcomes the study listed was the number of days that it took to reach a 50% reduction in symptoms as reported on a 12-Symptom scale. In Table 2, you can see that the statistical test they used to evaluate differences between groups for this end point produced a p-value of 0.97. Please provide an interpretation of this p-value, explaining what it means in terms of whether significant differences exist between the groups in the number of days it took to achieve a 50% reduction in symptoms on the 12-Symptom scale. JAMANetwork Open.Original Investigation | Public HealthEffect of High-Dose Zinc and Ascorbic Acid Supplementation vs Usual Careon Symptom Length and Reduction Among Ambulatory PatientsWith SARS-CoV-2 InfectionThe COVID A to Z Randomized Clinical TrialSuma Thomas, MD, MBA; Divyang Patel, MD, MS; Barbara Bittel, BSN, RN; Kathy Wolski, MPH; Qiuqing Wang, MS; Anirudh Kumar, MD, MS; Zachary J. Il'Giovine, MD;Reena Mehra, MD, MS; Carla McWilliams, MD; Steve E. Nissen, MD; Milind Y. Desai, MD, MBAAbstractIMPORTANCE There is limited evidence regarding early treatment of novel severe acute respiratorysyndrome coronavirus 2 (SARS-CoV-2) infection to mitigate symptom progression.OBJECTIVE To examine whether high-dose zinc and/or high-dose ascorbic acid reduce the severityor duration of symptoms compared with usual care among ambulatory patients with SARS-CoV-2infection.DESIGN, SETTING, AND PARTICIPANTS This multicenter, single health system randomized clinicalfactorial open-label trial enrolled 214 adult patients with a diagnosis of SARS-CoV-2 infectionconfirmed with a polymerase chain reaction assay who received outpatient care in sites in Ohio andFlorida. The trial was conducted from April 27, 2020, to October 14, 2020.INTERVENTION Patients were randomized in a 1:1:1:1 allocation ratio to receive either 10 days of zincgluconate (50 mg), ascorbic acid (8000 mg), both agents, or standard of care.OUTCOMES The primary end point was the number of days required to reach a 50% reduction insymptoms, including severity of fever, cough, shortness of breath, and fatigue (rated on a 4-pointscale for each symptom). Secondary end points included days required to reach a total symptomseverity score of O, cumulative severity score at day 5, hospitalizations, deaths, adjunctive prescribedmedications, and adverse effects of the study supplements.RESULTS A total of 214 patients were randomized, with a mean (SD) age of 45.2 (14.6) years and 132(61.7%) women. The study was stopped for a low conditional power for benefit with no significantdifference among the 4 groups for the primary end point. Patients who received usual care withoutsupplementation achieved a 50% reduction in symptoms at a mean (SD) of 6.7 (4.4) days comparedwith 5.5 (3.7) days for the ascorbic acid group, 5.9 (4.9) days for the zinc gluconate group, and 5.5(3.4) days for the group receiving both (overall P = .45). There was no significant difference insecondary outcomes among the treatment groups.CONCLUSIONS AND RELEVANCE In this randomized clinical trial of ambulatory patients diagnosedwith SARS-CoV-2 infection, treatment with high-dose zinc gluconate, ascorbic acid, or a combinationof the 2 supplements did not significantly decrease the duration of symptoms compared withstandard of care.TRIAL REGISTRATION Clinical Trials.gov Identifier: NCT04342728JAMA Network Open. 2021;4(2):e210369. doi:10.1001/jamanetworkopen.2021.0369Open Access. This is an open access article distributed under the terms of the CC-BY License.JAMA Network Open. 2021;4(2):e210369. doi:10.1001/jamanetworkopen.2021.0369Downloaded From: https://jamanetwork.com/ by a Samford University Library User on 03/13/2023Key PointsQuestion Do high-dose zinc, high-doseascorbic acid, and/or a combination ofthe 2 reduce the duration of symptomsof severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2)?COFindings In this randomized clinical trialof 214 patients with confirmed SARS-CoV-2 infection receiving outpatientcare, there was no significant differencein the duration of symptoms among the4 groups.Meaning These findings suggest thattreatment with zinc, ascorbic acid, orboth does not affect SARS-CoV-2symptoms.+ Visual Abstract+ Invited Commentary+ Supplemental contentAuthor affiliations and article information arelisted at the end of this article.February 12, 2021 1/10

Accepted Answer

This study examines the effects of high-dose zinc and ascorbic acid supplementation compared to…