Potential benefits and risks of omega-3 fatty acids supplementation to patients with COVID-19

Free Radic Biol Med. 2020 Aug 20:156:190-199. doi: 10.1016/j.freeradbiomed.2020.07.005. Epub 2020 Jul 10.

Abstract

Studies have shown that infection, excessive coagulation, cytokine storm, leukopenia, lymphopenia, hypoxemia and oxidative stress have also been observed in critically ill Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) patients in addition to the onset symptoms. There are still no approved drugs or vaccines. Dietary supplements could possibly improve the patient's recovery. Omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), present an anti-inflammatory effect that could ameliorate some patients need for intensive care unit (ICU) admission. EPA and DHA replace arachidonic acid (ARA) in the phospholipid membranes. When oxidized by enzymes, EPA and DHA contribute to the synthesis of less inflammatory eicosanoids and specialized pro-resolving lipid mediators (SPMs), such as resolvins, maresins and protectins. This reduces inflammation. In contrast, some studies have reported that EPA and DHA can make cell membranes more susceptible to non-enzymatic oxidation mediated by reactive oxygen species, leading to the formation of potentially toxic oxidation products and increasing the oxidative stress. Although the inflammatory resolution improved by EPA and DHA could contribute to the recovery of patients infected with SARS-CoV-2, Omega-3 fatty acids supplementation cannot be recommended before randomized and controlled trials are carried out.

Keywords: DHA; EPA; Inflammation; Oxidative stress; SARS-CoV-2; SPMs.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Betacoronavirus / pathogenicity
  • COVID-19
  • Coronavirus Infections / diet therapy*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / metabolism
  • Coronavirus Infections / virology
  • Cytokine Release Syndrome / diet therapy*
  • Cytokine Release Syndrome / epidemiology
  • Cytokine Release Syndrome / metabolism
  • Cytokine Release Syndrome / virology
  • Dietary Supplements*
  • Disseminated Intravascular Coagulation / diet therapy
  • Disseminated Intravascular Coagulation / epidemiology
  • Disseminated Intravascular Coagulation / metabolism
  • Disseminated Intravascular Coagulation / virology
  • Docosahexaenoic Acids / administration & dosage*
  • Eicosapentaenoic Acid / administration & dosage*
  • Humans
  • Hypoxia / diet therapy
  • Hypoxia / epidemiology
  • Hypoxia / metabolism
  • Hypoxia / virology
  • Leukopenia / diet therapy*
  • Leukopenia / epidemiology
  • Leukopenia / metabolism
  • Leukopenia / virology
  • Oxidative Stress
  • Pandemics*
  • Pneumonia, Viral / diet therapy*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / metabolism
  • Pneumonia, Viral / virology
  • Randomized Controlled Trials as Topic
  • Reactive Oxygen Species / antagonists & inhibitors
  • Reactive Oxygen Species / metabolism
  • SARS-CoV-2

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Reactive Oxygen Species
  • Docosahexaenoic Acids
  • Eicosapentaenoic Acid