Cohort Study Finds That Fish Oil Supplements Reduces The Risk Of COVID-19 Severity
: A new study by researchers from the Guangdong Academy of Medical Sciences-China, the Southern Medical University, Guangzhou-China, South China University of Technology, Guangzhou-China, Shantou University Medical College-China, University of California Los Angeles-USA and the Veterans Affairs Greater Los Angeles Healthcare System-USA involving a cohort study of data from the UK Biobank has found that regular use of fish oil supplements prevents the risk of severe COVID-19 outcomes.
The study team aimed to investigate the associations of habitual fish oil use with Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, hospital admission, or mortality with Corona Virus Disease-19 (COVID-19) in a large-scale population-based cohort study involving the UK Biobank.
A total of 110 440 participants aged 37 -73 years who completed a questionnaire on supplement use, which included fish oil at baseline were enrolled between 2006 and 2010 and followed up until 2022.
A total of 29 424 (26.6%) of the 110 440 participants reported habitual use of fish oil supplements. The multivariable adjusted hazard ratios for habitual users of fish oil versus non-users were 0.95 (0.93 to 0.98) for SARS-CoV-2 infection among participants with follow-up time less than 12.1 years but no significant associations were observed for participants with follow-up time more than 12.1 years.
For COVID-19-related outcomes, the hazard ratios were 0.79 (95% confidence interval 0.71 to 0.88) for COVID-19 hospital admission and 0.72 (0.60 to 0.87) for COVID-19 mortality. For COVID-19-related outcomes, the association seemed to be stronger among those with longstanding illness. The Cox proportional hazard analysis after propensity-score matching yielded consistent results.
The study findings concluded that habitual fish oil supplement is associated with a lower risk of hospital admission and mortality with COVID-19, but not associated with SARS-CoV-2 infection in the population with more than 12.1 years of follow-up.
The study findings were published on a preprint server and are currently being peer reviewed. https://www.medrxiv.org/content/10.1101/2022.09.14.22279933v1
This was the first study to specifically investigated whether regular fish oil use decreased the risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or had the capability to lower the risk of developing adverse coronavirus disease 2019 (COVID-19) outcomes, including hospitalization and death.
Although there is ample evidence that fish oil supplementation has a beneficial effect on human immune function, which could help reduce the risk of SARS-CoV-2-infection and improve the survival rate in COVID-19 patients, most of this data evidence is primarily from random controlled trials with inadequate sample sizes.
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has covered some of these previous studies and trials:
The study team said that overall, there is a lack of large-scale population-based cohort studies evaluating the usefulness of fish oil supplements in real-world settings.
For the research, the study team recruited 110,440 UK biobank participants (54.44% females) with a mean age of 55.5 years from centers across England, Scotland, and Wales. They asked them to fill out a detailed touch screen questionnaire at baseline to record the regular use of fish oil supplements. The study participants also provided biological samples and underwent physical measurements at baseline.
The study team identified COVID-19-related hospital admission and mortality from inpatient hospital data updated to September 30, 2021. The study follow-up continued for up to 12.1 years from the baseline assessment or ended at the time of COVID-19 diagnosis, inpatient hospitalization, or mortality, whichever occurred first.
The team subsequently utilized Cox proportional hazard models to evaluate the correlations between habitual fish oil use and three study outcomes, risk of SARS-CoV-2 infection, COVID-19-related hospital admission, and mortality.
The study team split the participants based on the time of follow-up into less than 12.1 years and greater than or equal to 12.1 years while evaluating the risk of SARS-CoV-2 infection. This time was the median follow-up time and the time of the Omicron emergence.
The research had three sets of models. First or the basic study model or model 1 was non-adjusted. Model 2 was a pre-adjusted model for baseline age and male or female gender. Model 3 was a multivariable-adjusted model accounting for several additional variables, including ethnicity, household income, smoking, and alcohol consumption, vegetable and non-oily fish consumption, and mineral and other dietary supplementation. In addition, they plotted weighted Kaplan-Meier curves to compare the event-free probability of regular fish oil users and non-users.
A total of 29424 participants reported using fish oil supplementation at baseline.
It was noted that the study population had more women, older people, previous smokers, and those who habitually used vitamin and mineral supplements. Additionally, these fish oil users showed a higher prevalence of longstanding hypertension and myocardial infarction.
The study model 2, adjusted for age and gender, showed a 25% and 31% reduction in the risk of COVID-19 hospital admission and mortality, respectively, among those habitually using fish oil.
The model 3, when fully-adjusted for all variables, showed fish oil use associated with adjusted hazard ratios (aHRs) of 0.79 and 0.72 for COVID-19 hospital admission and mortality, respectively. Although weighted Kaplan-Meier curves showed reduced risks of adverse COVID-19 outcomes with fish oil use, this model showed no significant associations between the two among participants with more than 12.1 years follow-up.
A past COVID-19 Supplements
study had showed that regular fish oil users had a 12% lower risk of SARS-CoV-2 infection in the UK when Omicron had not even emerged.
This current study however used the latest UK data, whereby in January 2022, Omicron caused over 99% of all sequenced cases.
This current study, thus, showed the varying impact of fish oil use on SARS-CoV-2 infection in different periods.
In the earlier period, fish oil use prevented SARS-CoV-2 infection, as observed in past study.However, the study team noted no such effect of fish oil used in the later stage when Omicron became the predominant SARS-CoV-2 variant in the UK.
The population followed up for more than 12.1 years showed no signs of being at lower risk of SARS-CoV-2 infection due to regular fish oil use.
However, the study analysis using a fully-adjusted Cox proportional hazard model showed that habitual fish oil use was consistently associated with a lower risk of COVID-19-related hospital admission and mortality.
The research also shed light on the biological mechanisms which govern fish oil use-related benefits for COVID-19-related outcomes. The main ingredient of fish oil is omega-3 polyunsaturated fatty acids (n-3 PUFA), which have powerful anti-inflammatory properties. A growing body of evidence suggests that n-3 PUFAs attenuate the uncontrolled immune response in the lungs following bacterial or viral infections. Thus, fish oil use could improve COVID-19 clinical outcomes, especially in hypertensive, oncologic, and diabetic patients.
The study team emphasized the urgent need for large-scale randomized controlled studies to confirm their findings.
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