SIB# 438 - Fish Oils and Covid Deaths

 

The Study: Blood omega-3 fatty acids and death from COVID-19: A pilot study 

Overview:  This is a retrospective study of 100 patients hospitalized for Covid-19. The study was designed to test the hypothesis that levels of Omega-3 fatty acids (EPA and DHA) “would be inversely associated with risk for death”.

Key Points: 

  • “Severe COVID-19 disease and death is, in part, mediated by rapid elevations of inflammatory cytokines”, also known as the “cytokine storm”. Accordingly, any preventive strategies which might minimize catastrophic levels of cytokine release are potentially beneficial.  

  • Randomized clinical trial of long-chain omega-3 s (DHA and EPA) found in fish oils have been shown effective in lowering cytokine levels in non-COVID-19 settings. 

  • EPA and DHA are also precursors to a wide range of inflammation-resolving mediators.

  •  “Accordingly, higher intakes of EPA and DHA in the red blood cells (hereafter called Omega-3 Index or O3I) have been proposed to lower the risk for adverse outcomes from COVID-19.”

  •  The study looked at 100 subjects hospitalized confirmed COVID-19 infection who met the criteria for inclusion (availability of basic demographic data, known clinical outcomes and an EDTA blood sample (drawn within 10 days of diagnosis) which would allow for analysis of the Omega 3 Index. 

  • Subjects were divided into quartiles according to their Omega -3 Index and further  stratified according to age, sex and whether or not the patient had a “do not resuscitate” (DNR) status.

  •  As is common in patients with severe Covid disease, the subjects tended to be predominantly older males (mean age over 70) and nearly 40 percent had a DNR order in place.

     

Author’s Conclusions: Patients with higher levels of Omega 3 fatty acids ( Omega 3 Indexes at 5.7% or greater) showed a  75% lower risk for death compared with those below that value. The authors acknowledge that the power of this study is reduced due to the small sample size but emphasize that the strong trends of the data suggests that “more well powered studies are clearly needed.”  

Reviewer's Comments: The study has potential practical application for field practitioners. The anti-inflammatory benefits of fish oil supplementation are well established and would suggest there is at least a potential here for a benefit in terms of Covid-19 survivability with minimal potential for down side effects. Accordingly, practitioners may want to consider suggesting Omega 3 supplementation as a possible preventive measure. Note that this is a completely separate consideration from the benefits (or lack thereof) of any potential merits of fish oil supplementation for cardiovascular disease have recently come under some criticism.  

Reviewer:  Mark R. Payne DC 

Reference:  Asher A, Tintle N, Myers M et al. Blood omega-3 fatty acids and eath from COVID-19: A pilot study. Prostaglandins, Leukotrienes and Essential Fatty Acids. Published January 20. 2021. DOI: 

Link to Full Text: https://www.plefa.com/article/S0952-3278(21)00013-2/fulltext#%20

Mark R. Payne DC