Association of omega-3 fatty acids (EPA, DHA, DPA) and vitamin D with mortality and morbidity outcomes in COVID-19 patients: the COMED study.
Long-chain omega-3 fatty acids (FAs) and vitamin D (VitD) are implicated in the modulation of immune responses and inflammatory processes within the body. The COMED study evaluated levels of DHA, EPA and DPA (expressed as a modified omega-3 index, mO3I, defined as the percentage of these FAs relative to total FAs in whole blood) and VitD in patients with COVID-19 in relation to mortality and severe disease, as well as additional morbidity-related outcomes, including probability of hospitalisation and length of hospital stay (LOS).
A total of 160 patients were enrolled, of whom 28 died during follow-up. Associations between mO3I and VitD levels and clinical outcomes were analysed using logistic and linear regression models adjusted for age, sex, BMI, smoking, diabetes mellitus, and hypertension.
Higher mO3I levels (Q4 ≥ 6.39%) were associated with lower odds of death (OR = 0.24, 95% CI: 0.05-0.87) and lower probability of hospitalisation (OR = 0.28, 95% CI: 0.09-0.91) compared with lower mO3I levels (Q1-Q3). Higher VitD levels (Q4 ≥ 71.9 nmol/L) were associated with a shorter LOS by 2.19 days compared with Q1-Q3, while higher levels (Q2-Q4 > 36.7 nmol/L) shortened LOS by 2.96 days compared with Q1. Age was the strongest predictor of mortality, severe disease, and LOS; BMI increased the probability of severe disease; smoking prolonged LOS.
Higher mO3I levels were associated with lower odds of death, with similar trends observed for hospitalisation, whereas higher VitD levels were associated with a shorter LOS. Nutritional biomarkers and modifiable lifestyle factors, such as body weight and smoking, were associated with differences in clinical outcomes in COVID-19. However, the observational design of the study precludes causal interpretations.
A total of 160 patients were enrolled, of whom 28 died during follow-up. Associations between mO3I and VitD levels and clinical outcomes were analysed using logistic and linear regression models adjusted for age, sex, BMI, smoking, diabetes mellitus, and hypertension.
Higher mO3I levels (Q4 ≥ 6.39%) were associated with lower odds of death (OR = 0.24, 95% CI: 0.05-0.87) and lower probability of hospitalisation (OR = 0.28, 95% CI: 0.09-0.91) compared with lower mO3I levels (Q1-Q3). Higher VitD levels (Q4 ≥ 71.9 nmol/L) were associated with a shorter LOS by 2.19 days compared with Q1-Q3, while higher levels (Q2-Q4 > 36.7 nmol/L) shortened LOS by 2.96 days compared with Q1. Age was the strongest predictor of mortality, severe disease, and LOS; BMI increased the probability of severe disease; smoking prolonged LOS.
Higher mO3I levels were associated with lower odds of death, with similar trends observed for hospitalisation, whereas higher VitD levels were associated with a shorter LOS. Nutritional biomarkers and modifiable lifestyle factors, such as body weight and smoking, were associated with differences in clinical outcomes in COVID-19. However, the observational design of the study precludes causal interpretations.
Authors
Bischofová Bischofová, Měřínská Měřínská, Beňovská Beňovská, Husa Husa, Řehůřková Řehůřková, Klinerová Klinerová, Bourková Bourková, Horáková Horáková, Dvořáková Dvořáková, Hoffmannová Hoffmannová, Podborská Podborská, Ruprich Ruprich
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