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ascorbic acid + bromelain + quercetin + zinc acetate is a quadruple therapy combination evaluated by the Ministry of Health, Saudi Arabia, for the treatment of moderate to severe COVID-19. The regimen, studied in a Phase 4 clinical trial (NCT04468139), utilizes the synergistic effects of its components to inhibit viral replication and mitigate the inflammatory response. Ascorbic acid (Vitamin C) serves as a potent antioxidant and enzymatic cofactor that supports immune potentiation. Quercetin acts as a zinc ionophore, facilitating the intracellular transport of zinc, which subsequently inhibits the viral RNA-dependent RNA polymerase. Bromelain contributes anti-inflammatory and immunomodulatory properties by activating natural killer cells and modulating the production of cytokines such as IL-2, IL-6, and GM-CSF. This combination therapy aims to prevent poor prognosis by addressing the cytokine storm and thrombotic complications associated with SARS-CoV-2 infection.
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