Abstract
Pooled evidence conveys the association between polyunsaturated fatty acids and infectious disease. SARS-CoV-2, an enveloped mRNA virus, was also reported to interact with polyunsaturated fatty acids. The present review explores the possible mode of action, immunology, and consequences of these polyunsaturated fatty acids during the viral infection. Polyunsaturated fatty acids control protein complex formation in lipid rafts associated with the function of two SARS-CoV-2 entry gateways: angiotensin-converting enzyme-2 and cellular protease transmembrane protease serine-2. Therefore, the viral entry can be mitigated by modulating polyunsaturated fatty acids contents in the body. α-Linolenic acid is the precursor of two clinically important eicosanoids eicosapentaenoic acid and docosahexaenoic acid, the members of ω-3 fats. Resolvins, protectins, and maresins derived from docosahexaenoic acid suppress inflammation and augment phagocytosis that lessens microbial loads. Prostaglandins of 3 series, leukotrienes of 5 series, and thromboxane A3 from eicosapentaenoic acid exhibit anti-inflammatory, vasodilatory, and platelet anti-aggregatory effects that may also contribute to the control of pre-existing pulmonary and cardiac diseases. In contrast, ω-6 linoleic acid-derived arachidonic acid increases the prostaglandin G2, lipoxins A4 and B4, and thromboxane A2. These cytokines are pro-inflammatory and enhance the immune response but aggravate the COVID-19 severity. Therefore, the rational intake of ω-3-enriched foods or supplements might lessen the complications in COVID-19 and might be a preventive measure.
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Key Points
Recent pooled evidence has consistently reported that chronic diseases like chronic obstructive pulmonary disease (COPD), cardiovascular disease (CVD), cancer, cerebrovascular accident (CVA), diabetes, hypertension, and chronic kidney disease have an association with the severity among COVID-19 patients. The anti-inflammatory metabolites of AA, EPA, and DHA, collectively named as specialized pro-resolving lipid mediators (SPMs) such as lipoxins, resolvins, protectins, and maresins, suppress inflammation. The augmented phagocytosis of macrophages and other immunocytes decreases the microbial load and enhances the healing process. The present review aims to demonstrate the effect and rational selection of PUFAs to lessen COVID-19 severity with probable mechanisms.
SARS-CoV-2 is a highly contagious virus which spread through respiratory droplets. Besides the respiratory system, multisystem and multi-organ involvement of the virus triggers a cytokine storm that is an indicator of disease severity. Polyunsaturated fatty acids, a cluster of clinically significant fats, are the considerable option to lessen the severity. It has a substantial role in the immunological defense against viral entry, localization, and replication to new copies. However, it is also associated with respiratory health by controlling blood rheology and surfactant production in the lung. To add more, PUFAs might significantly benefit COVID-19 comorbidities such as cardiovascular disease, COPD, and diabetes. However, all PUFAs are not functionally the same. The members of ω-3 PUFAs (ALA, EPA, and DHA) are associated with anti-inflammatory action, whereas ω-6 PUFAs (LA, AA) are pro-inflammatory. Exceptionally, few SPMs like lipoxin derived from the AA show anti-inflammatory action that might lessen COVID-19 severity. Therefore, the ω-3 PUFA-enriched food or supplements is a good option in the emergence cytokine race and might decrease COVID-19 complications. Further clinical and retrospective study for the use of PUFAs in COVID-19 management is warranted.