Nutritional Genomics and Inflammation Laboratory, Department of Nutrition, School of Public Health, University of São Paulo, 01246-904, São Paulo, Brazil; Food Research Center (FoRC), CEPID-FAPESP, Research Innovation and Dissemination Center of São Paulo Research Foundation, São Paulo, 05468-140, Brazil.
LADAF, Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo-SP, Brazil.
Free Radic Biol Med. 2020 Aug 20;156:190-199. doi: 10.1016/j.freeradbiomed.2020.07.005. Epub 2020 Jul 10.
Studies have shown that infection, excessive coagulation, cytokine storm, leukopenia, lymphopenia, hypoxemia and oxidative stress have also been observed in critically ill Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) patients in addition to the onset symptoms. There are still no approved drugs or vaccines. Dietary supplements could possibly improve the patient's recovery. Omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), present an anti-inflammatory effect that could ameliorate some patients need for intensive care unit (ICU) admission. EPA and DHA replace arachidonic acid (ARA) in the phospholipid membranes. When oxidized by enzymes, EPA and DHA contribute to the synthesis of less inflammatory eicosanoids and specialized pro-resolving lipid mediators (SPMs), such as resolvins, maresins and protectins. This reduces inflammation. In contrast, some studies have reported that EPA and DHA can make cell membranes more susceptible to non-enzymatic oxidation mediated by reactive oxygen species, leading to the formation of potentially toxic oxidation products and increasing the oxidative stress. Although the inflammatory resolution improved by EPA and DHA could contribute to the recovery of patients infected with SARS-CoV-2, Omega-3 fatty acids supplementation cannot be recommended before randomized and controlled trials are carried out.
研究表明，重症严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）患者除了发病症状外，还会出现感染、过度凝血、细胞因子风暴、白细胞减少症、淋巴细胞减少症、低氧血症和氧化应激。目前还没有批准的药物或疫苗。膳食补充剂可能有助于改善患者的康复情况。ω-3 脂肪酸，特别是二十碳五烯酸（EPA）和二十二碳六烯酸（DHA），具有抗炎作用，可以改善一些患者入住重症监护病房（ICU）的需求。EPA 和 DHA 会取代磷脂膜中的花生四烯酸（ARA）。当被酶氧化时，EPA 和 DHA 有助于合成炎症反应较小的类二十烷酸和专门的促解决脂质介质（SPM），如 resolvins、maresins 和 protectins。这可以减轻炎症。相比之下，一些研究报告称，EPA 和 DHA 可以使细胞膜更容易受到活性氧介导的非酶氧化，从而形成潜在有毒的氧化产物，并增加氧化应激。尽管 EPA 和 DHA 改善的炎症消退可能有助于感染 SARS-CoV-2 的患者康复，但在进行随机对照试验之前，不能推荐使用ω-3 脂肪酸补充剂。
