{"title":"Efficacy of omega-3 fatty acids for hospitalized COVID-19 patients: a systematic review and meta-analysis of randomized controlled trials.","authors":"Han-Yang Yue, Jun Zeng, Yu Wang, Meng-Jie Deng, Wei Peng, Xin Tan, Hua Jiang","doi":"10.6133/apjcn.202309_32(3).0002","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Emerging expert consensuses and guidelines recommend that omega-3 fatty acids may have anti-inflammatory effects in hospitalized patients with coronavirus disease (COVID-19). However, these recommendations are based on pathophysiological studies of inflammation rather than direct clinical evidence. We conducted this systematic review and meta-analysis to evaluate the efficacy of omega-3 fatty acid supplementation in hospitalized patients with COVID-19.</p><p><strong>Methods and study design: </strong>We retrieved literature from PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), WANFANG, Chinese Biomedical Literature Database, and Cochrane Library databases up to May 1, 2023. Data from studies comparing omega-3 fatty acids with a placebo or other pharmaceutical nutrients were analyzed.</p><p><strong>Results: </strong>Of 3032 records, 42 full-text articles were reviewed, five eligible studies were identified, and one study was found in the references. In total of six studies involving 273 patients were included, pooled, and analyzed. Compared to the control group, omega-3 fatty acid intervention reduced the overall mortality of hospitalized patients with COVID-19 (RR=0.76; 95% CI, [0.61, 0.93]; p=0.010). No serious or unexpected drug-related adverse events were observed. No statistical significance was observed in inflammatory markers such as CRP (MD=-9.69; 95% CI, [-22.52, 3.15]; p=0.14; I2=97%) and IL-6; however, the neutrophil/lymphocyte ratio was significantly lower in the omega-3 FAs group on day 7 of intervention (p < 0.001).</p><p><strong>Conclusions: </strong>Omega-3 fatty acid administration may be associated with reduced mortality in hospitalized patients with COVID-19. Given the small sample size of enrolled studies, more rigorous and large-scale trials are urgently needed in the future to verify its efficacy.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"32 3","pages":"308-320"},"PeriodicalIF":1.3000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11090385/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia Pacific journal of clinical nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.6133/apjcn.202309_32(3).0002","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
Abstract
Background and objectives: Emerging expert consensuses and guidelines recommend that omega-3 fatty acids may have anti-inflammatory effects in hospitalized patients with coronavirus disease (COVID-19). However, these recommendations are based on pathophysiological studies of inflammation rather than direct clinical evidence. We conducted this systematic review and meta-analysis to evaluate the efficacy of omega-3 fatty acid supplementation in hospitalized patients with COVID-19.
Methods and study design: We retrieved literature from PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), WANFANG, Chinese Biomedical Literature Database, and Cochrane Library databases up to May 1, 2023. Data from studies comparing omega-3 fatty acids with a placebo or other pharmaceutical nutrients were analyzed.
Results: Of 3032 records, 42 full-text articles were reviewed, five eligible studies were identified, and one study was found in the references. In total of six studies involving 273 patients were included, pooled, and analyzed. Compared to the control group, omega-3 fatty acid intervention reduced the overall mortality of hospitalized patients with COVID-19 (RR=0.76; 95% CI, [0.61, 0.93]; p=0.010). No serious or unexpected drug-related adverse events were observed. No statistical significance was observed in inflammatory markers such as CRP (MD=-9.69; 95% CI, [-22.52, 3.15]; p=0.14; I2=97%) and IL-6; however, the neutrophil/lymphocyte ratio was significantly lower in the omega-3 FAs group on day 7 of intervention (p < 0.001).
Conclusions: Omega-3 fatty acid administration may be associated with reduced mortality in hospitalized patients with COVID-19. Given the small sample size of enrolled studies, more rigorous and large-scale trials are urgently needed in the future to verify its efficacy.
背景和目的:新出现的专家共识和指南建议,ω-3脂肪酸可能对冠状病毒病(新冠肺炎)住院患者具有抗炎作用。然而,这些建议是基于炎症的病理生理学研究,而不是直接的临床证据。我们进行了这项系统综述和荟萃分析,以评估补充ω-3脂肪酸对COVID-19住院患者的疗效。方法和研究设计:我们检索了截至2023年5月1日的PubMed、Web of Science、Embase、中国知识基础设施(CNKI)、WANFANG、中国生物医学文献数据库和Cochrane图书馆数据库中的文献。分析了将ω-3脂肪酸与安慰剂或其他药物营养素进行比较的研究数据。结果:在3032份记录中,共回顾了42篇全文文章,确定了5项符合条件的研究,并在参考文献中找到了一项研究。共有6项研究涉及273名患者,纳入、汇总和分析。与对照组相比,ω-3脂肪酸干预降低了新冠肺炎住院患者的总体死亡率(RR=0.76;95%CI,[0.61,0.93];p=0.010)。未观察到严重或意外的药物相关不良事件。炎症标志物如CRP(MD=-9.69;95%CI,[22.52,3.15];p=0.14;I2=97%)和IL-6无统计学意义;然而,在干预的第7天,ω-3脂肪酸组的中性粒细胞/淋巴细胞比率显著降低(p<0.001)。鉴于参与研究的样本量较小,未来迫切需要更严格和大规模的试验来验证其疗效。
期刊介绍:
The aims of the Asia Pacific Journal of Clinical Nutrition
(APJCN) are to publish high quality clinical nutrition relevant research findings which can build the capacity of
clinical nutritionists in the region and enhance the practice of human nutrition and related disciplines for health
promotion and disease prevention. APJCN will publish
original research reports, reviews, short communications
and case reports. News, book reviews and other items will
also be included. The acceptance criteria for all papers are
the quality and originality of the research and its significance to our readership. Except where otherwise stated,
manuscripts are peer-reviewed by at least two anonymous
reviewers and the Editor. The Editorial Board reserves the
right to refuse any material for publication and advises
that authors should retain copies of submitted manuscripts
and correspondence as material cannot be returned. Final
acceptance or rejection rests with the Editorial Board