Omega-3 polyunsaturated fatty acids and the psychiatric post-acute sequelae of COVID-19: A one-year retrospective cohort analysis of 33,908 patients

Ting-Hui Liu; Chung-Han Ho; Daniel Tzu-Li Chen; Jheng-Yan Wu; Po-Yu Huang; Chih-Cheng Lai; Kuang-Yang Hsieh; Kuan-Pin Su

doi:10.1016/j.bbi.2023.09.008

Omega-3 polyunsaturated fatty acids and the psychiatric post-acute sequelae of COVID-19: A one-year retrospective cohort analysis of 33,908 patients

Brain Behav Immun. 2023 Nov:114:453-461. doi: 10.1016/j.bbi.2023.09.008. Epub 2023 Sep 15.

Authors

Ting-Hui Liu¹, Chung-Han Ho², Daniel Tzu-Li Chen³, Jheng-Yan Wu⁴, Po-Yu Huang⁵, Chih-Cheng Lai⁶, Kuang-Yang Hsieh¹, Kuan-Pin Su⁷

Affiliations

¹ Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan.
² Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.
³ School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Biomedicine, College of Medicine, China Medical University, Taichung.
⁴ Department of Nutrition, Chi Mei Medical Center, Tainan City, Taiwan.
⁵ Department of Internal Medicine, Chi Mei Medical Center, Tainan City, Taiwan.
⁶ Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
⁷ Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; King's College London, London, UK; College of Medicine, China Medical University, Taichung, Taiwan; An-Nan Hospital, China Medical University, Tainan, Taiwan. Electronic address: cobol@cmu.edu.tw.

PMID: 37716377
DOI: 10.1016/j.bbi.2023.09.008

Abstract

Background: Early prevention and management of psychiatric symptoms in long COVID (or post-COVID-19 conditions) are crucial for reducing long-term disability. Existing clinical guidelines recommend the use of omega-3 polyunsaturated fatty acids (PUFAs) as a promising therapeutic approach for various common psychiatric disorders due to their anti-inflammatory and neuroprotective characteristics. This study aims to investigate the potential efficacy of omega-3 PUFAs in alleviating the psychiatric sequelae following COVID-19.

Methods: This 1-year retrospective cohort study used the TriNetX electronic health records network to examine the effects of omega-3 PUFAs supplements on psychiatric sequelae in adults diagnosed with COVID-19. Using propensity-score matching, the study compared those who used omega-3 PUFAs supplements with those who did not, assessing outcomes including depression, anxiety disorders, insomnia, and other somatic conditions up to a year after COVID-19 diagnosis.

Results: In 16,962 patients who received omega-3 PUFAs supplements and 2,248,803 who did not, omega-3 supplementation significantly reduced the risk of developing psychiatric sequelae post-COVID-19 diagnosis (HR, 0.804; 95% CI, 0.729 to 0.888). Specifically, the risks for depression (HR, 0.828; 95% CI, 0.714 to 0.960), anxiety disorders (HR, 0.833; 95% CI, 0.743 to 0.933), and insomnia (HR, 0.679; 95% CI, 0.531 to 0.869) were reduced in the omega-3 group. This effect was consistent across sex, race, 18-59 age group, and patients with less than two doses of the COVID-19 vaccine. The omega-3 group also had a lower risk of cough and myalgia, but no significant difference was noted for other symptoms like chest pain, abnormal breathing, abdominal issues, fatigue, headache, and cognitive symptoms.

Conclusion: Omega-3 PUFAs may require re-evaluation as a preventive strategy against adverse mental health outcomes post-COVID-19 in placebo-controlled clinical trials.

Keywords: Long-COVID; Omega-3 PUFAs; Post-COVID-19 condition; Psychiatric; SARS-CoV-2.