Effect of Omega-3 fatty acids supplementation on serum level of C-reactive protein in patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials

Taha, Amira Mohamed; Shaarawy, Ahmad Shehata; Omar, Mohamed Mosad; Abouelmagd, Khaled; Shalma, Noran Magdy; Alhashemi, Mais; Ahmed, Hala; Allam, Ahmed Hafez; Abd-ElGawad, Mohamed

doi:10.1186/s12967-022-03604-3

Cited by 11 publications

(8 citation statements)

References 41 publications

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“…DHA could be metabolized by macrophages to produce d -series dissolution, maresin, and protective protein, which can inhibit the secretion of inflammatory factors by macrophages, induce anti-inflammatory transformation and promote efferocytosis. , Therefore, we introduced DHA into the biomimetic hybrid nanovesicles ANeu-DDAB, to play an excellent anti-inflammatory and pro-resolution synergistic effect. First, we explored the effects of different DHA dosages on the particle size, zeta potential, drug loading capacity, and encapsulation efficiency of ANeu-DDAB.…”

Section: Resultsmentioning

confidence: 99%

Engineered Biomimetic Nanovesicles Based on Neutrophils for Hierarchical Targeting Therapy of Acute Respiratory Distress Syndrome

Li,

Qiao,

Liu

et al. 2024

ACS Nano

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Acute Respiratory Distress Syndrome (ARDS) is a clinically severe respiratory disease that causes severe medical and economic burden. To improve therapeutic efficacy, effectively targeting delivery to the inflamed lungs and inflamed cells remains an ongoing challenge. Herein, we designed engineered biomimetic nanovesicles (DHA@ANeu-DDAB) by fusion of lung-targeting functional lipid, neutrophil membrane containing activated β 2 integrins, and the therapeutic lipid, docosahexaenoic acid (DHA). By the advantage of lung targeting lipid and β 2 integrin targeting adhesion, DHA@ANeu-DDAB can first target lung tissue and further target inflammatory vascular endothelial cells, to achieve "tissue first, cell second" hierarchical delivery. In addition, the β 2 integrins in DHA@ANeu-DDAB could bind to the intercellular cell adhesion molecule-1/2 (ICAM-1/2) ligand on the endothelium in the inflamed blood vessels, thus inhibiting neutrophils' infiltration in the blood circulation. DHA administration to inflamed lungs could effectively regulate macrophage phenotype and promote its anti-inflammatory activity via enhanced biosynthesis of specialized pro-resolving mediators. In the lipopolysaccharide-induced ARDS mouse model, DHA@ ANeu-DDAB afforded a comprehensive and efficient inhibition of lung inflammation and promoted acute lung damage repair. Through mimicking physiological processes, these engineered biomimetic vesicles as a delivery system possess good potential in targeting therapy for ARDS.

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Section: Resultsmentioning

confidence: 99%

Engineered Biomimetic Nanovesicles Based on Neutrophils for Hierarchical Targeting Therapy of Acute Respiratory Distress Syndrome

Li,

Qiao,

Liu

et al. 2024

ACS Nano

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“…The second lipid-lowering drug that was investigated in two trials is omega-3. Supplementation with omega-3 reduces systemic inflammation in SARS-CoV-2 infection by reducing the CRP levels [ 38 ]. Moreover, blood levels of omega-3 were lower in more severe forms of COVID-19 [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Adjunctive therapy with lipid-lowering agents in COVID-19: a systematic review and meta-analysis of randomized controlled trials

et al. 2023

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Background Many commonly used drugs were evaluated as repurposed treatment options since the emergence of the COVID-19 pandemic. The benefit of lipid-lowering agents has been controversial in this regard. In this systematic review, we assessed the effect of these medications as adjunctive therapy in COVID-19 by the inclusion of randomized controlled trials (RCTs). Methods We searched four international databases including PubMed, the Web of Science, Scopus, and Embase for RCTs in April 2023. The primary outcome was mortality, while other efficacy indices were considered secondary outcomes. In order to estimate the pooled effect size of the outcomes, considering the odds ratio (OR) or standardized mean difference (SMD) and 95% confidence interval (CI), random-effect meta-analyses was conducted. Results Ten studies involving 2,167 COVID-19 patients using statins, omega-3 fatty acids, fenofibrate, PCSK9 inhibitors, and nicotinamide as intervention compared to control or placebo, were included. No significant difference was found in terms of mortality (OR 0.96, 95% CI 0.58 to 1.59, p-value = 0.86, I2 = 20.4%) or length of hospital stay (SMD -0.10, 95% CI -0.78 to 0.59, p-value = 0.78, I2 = 92.4%) by adding a statin to the standard of care. The trend was similar for fenofibrate and nicotinamide. PCSK9 inhibition, however, led to decreased mortality and an overall better prognosis. Omega-3 supplementation showed contradicting results in two trials, suggesting the need for further evaluation. Conclusion Although some observational studies found improved outcomes in patients using lipid-lowering agents, our study found no benefit in adding statins, fenofibrate, or nicotinamide to COVID-19 treatment. On the other hand, PCSK9 inhibitors can be a good candidate for further assessment. Finally, there are major limitations in the use of omega-3 supplements in treating COVID-19 and more trials are warranted to evaluate this efficacy.

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“…Omega-3 supplementation was found to have promising effects on acidosis and renal function, possibly improving clinical outcomes in SARS-COV-2 patients ( 51 ). a systematic review and meta-analysis of randomized controlled trials on the effect of Omega-3 fatty acids supplementation in patients with SARS-COV-2 have reported that Omega-3 supplementations have been associated with alleviating the inflammatory response by the CRP level reduction ( 52 ).…”

Section: Lipidmentioning

confidence: 99%

Potential of macronutrients and probiotics to boost immunity in patients with SARS-COV-2: a narrative review

Mardi,

Kamran,

Pourfarzi

et al. 2023

Front. Nutr.

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Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) may cause inflammation and increased cytokine secretion. Dietary factors may play an important role in enhancing the immune responses against infectious diseases such as SARS-COV-2. This narrative review aims to determine the effectiveness of macronutrients and probiotics to improve immunity in SARS-COV-2 patients. Dietary proteins may boost pulmonary function in SARS-COV-2 patients through inhibitory effects on the Angiotensin-converting enzyme (ACE) and reduce Angiotensin (ANG-II). Moreover, omega-3 fatty acids may improve oxygenation, acidosis, and renal function. Dietary fiber may also produce anti-inflammatory effects by reducing the level of high-sensitivity C-Reactive Protein (hs-CRP), Interleukin (IL-6), and Tumor necrosis factor (TNF-α). In addition, some evidence indicates that probiotics significantly improve oxygen saturation which may enhance survival rate. In conclusion, the consumption of a healthy diet including adequate macronutrients and probiotic intake may decrease inflammation and oxidative stress. Following this dietary practice is likely to strengthen the immune system and have beneficial effects against SARS-COV-2.

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Effect of Omega-3 fatty acids supplementation on serum level of C-reactive protein in patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials

Cited by 11 publications

References 41 publications

Engineered Biomimetic Nanovesicles Based on Neutrophils for Hierarchical Targeting Therapy of Acute Respiratory Distress Syndrome

Engineered Biomimetic Nanovesicles Based on Neutrophils for Hierarchical Targeting Therapy of Acute Respiratory Distress Syndrome

Adjunctive therapy with lipid-lowering agents in COVID-19: a systematic review and meta-analysis of randomized controlled trials

Potential of macronutrients and probiotics to boost immunity in patients with SARS-COV-2: a narrative review

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