Is there a relationship between the level of omega-3 fatty acids in the blood and death from COVID-19?
OmegaMatters: Episode – 1
Hosts: Drs. Bill Harris & Kristina Harris Jackson
Guests: Drs. Arash Asher & Michael Meyers
Key takeaways from this Episode:
- Hosts and guests explore recently published paper on the Omega-3 Index and COVID-19: Blood omega-3 fatty acids and death from COVID-19: A Pilot Study
- There have been several review papers theorizing that omega-3s might help fight COVID-19, but is the first published paper to confirm some of the hypotheses behind omega-3s and their role in mediating inflammation
- Many chronic diseases today are rooted in inflammation produced in large part by cytokines
- A “cytokine storm” happens when the body releases too many inflammatory compounds to help fight an infection (i.e., cytokines), resulting in damage to vital organs like the lungs and heart
- Inflammation resolving mediators (IRMs), also known as specialized proresolving mediators (SPMs), are produced by the omega-3s EPA and DHA to help resolve inflammation
- How omega-3s help calm the (cytokine) storm produced by COVID-19
- Researchers analyzed blood from patients who came into the hospital with COVID-19, not knowing whether they died or eventually returned to health
- The only other details researchers knew about these people were age and gender
- Blood samples from 100 people were measured and arranged into 4 quartiles based on their Omega-3 Index score — ranked them from highest to lowest
- The highest quartile included samples from people who had a 5.7% Omega-3 Index or above (an optimal Omega-3 Index is 8%; the average American is around 4-5%)
- What they found was that people in the highest quartile were 75% less likely to die from COVID-19 (although this association was only close to statistical significance; more data needed).
- There are currently 18 clinical trials going on treating patients with omega-3s; however, Drs. Harris and Jackson are a little skeptical about loading someone up with omega-3 once they arrive in the hospital with COVID; they believe it is far better to enter the hospital with a high Omega-3 Index
- In this vein, both the show hosts and guests believe omega-3s should be viewed more as a preventative step vs. treatment simply because it takes time for omega-3s EPA and DHA to become incorporated into cell membranes and then make the protective substances (i.e., IRMs) that can help weather the storm of COVID-19
- Asher also believes it is possible that people with a higher Omega-3 Index could have also been in better general health — nonsmokers, active lifestyle, good diet, etc.
- What Drs. Asher and Harris are proposing for the next study is to look at a larger group — ~500 — in order to take a deeper dive into those who had diabetes or CVD or were smokers or had other comorbidities, so that the researchers can make more rational conclusions about this data
- Meyers said it is important to keep in mind that the people in this study had a certain blood level of omega-3 (i.e., Omega-3 Index) upon admission to the hospital, which represents a 60-90 days window of their omega-3 intake, which supports the premise of omega-3 fatty acids as more preventative than treatment
- Omega-3 is not the beginning or end of treatment for COVID-19; it is one factor of many
- Still, getting more omega-3 in your diet is just one piece, but it appears to be an important piece — one that is inexpensive, like vitamin D, and for which there has been good data to support their utility in shoring up the body’s defenses
- Funding for a larger study to confirm these pilot findings is necessary
- For more information on ways to support this larger study, visit the COVID page on FARI’s website
Background on Omega-3 Index / COVID-19 Pilot Study:
Researchers with the Fatty Acid Research Institute (FARI) and collaborators at Cedars-Sinai Medical Center in Los Angeles and in Orange County, CA, have published the first direct evidence that higher omega-3 blood levels may reduce risk for death from COVID-19 infection. The report was published in the journal Prostaglandins, Leukotrienes and Essential Fatty Acids on January 20, 2021.
There are several papers in the medical literature hypothesizing that omega-3 fatty acids should have beneficial effects in patients with COVID-19 infection, but to date, there are no published studies supporting that hypothesis.
This study included 100 patients admitted to the hospital with COVID-19 for whom admission blood samples had been stored. Clinical outcomes for these patients were obtained and blood was analyzed for the Omega-3 Index (O3I) at OmegaQuant Analytics (Sioux Falls, SD). Fourteen of the patients died.
The 100 patients were grouped into four quartiles according to their O3I, with 25% of the patients in each quartile. There was one death in the top quartile (i.e., 1 death out of 25 patients with O3I>5.7%), with 13 deaths in the remaining patients (i.e., 13 deaths out of 75 patients with O3I<5.7%).
In age-and-sex adjusted regression analyses, those in the highest quartile (O3I >5.7%) were 75% less likely to die compared with those in the lower three quartiles (p=0.07). Stated another way, the relative risk for death was about four times higher in those with a lower O3I (<5.7%) compared to those with higher levels.
“While not meeting standard statistical significance thresholds, this pilot study – along with multiple lines of evidence regarding the anti-inflammatory effects of EPA and DHA – strongly suggests that these nutritionally available marine fatty acids may help reduce risk for adverse outcomes in COVID-19 patients. Larger studies are clearly needed to confirm these preliminary findings,” said Arash Asher, MD, the lead author on this study.
Agreeing with Dr. Asher, cardiology researcher and co-developer with Dr. Harris of the Omega-3 Index, Clemens von Schacky, MD, (CEO, Omegametrix GmbH, Martinsried, Germany, and not involved with the study) said, “Asher et al have demonstrated that a low Omega-3 Index might be a powerful predictor for death from COVID-19. Although encouraging, their findings clearly need to be replicated.”
Omega-3 expert James H. O’Keefe, Jr., MD, (Director of Preventive Cardiology, Saint Luke’s Mid America Heart Institute, Kansas City, MO, and also not involved with the study) observed, “An excessive inflammatory response, referred to as a ‘cytokine storm,’ is a fundamental mediator of severe COVID-19 illness. Omega-3 fatty acids (DHA and EPA) have potent anti-inflammatory activities, and this pilot study provides suggestive evidence that these fatty acids may dampen COVID-19’s cytokine storm.”
The research team is currently seeking funding to expand upon these preliminary observations. Individuals and organizations that want to support this research are encouraged to visit FARI’s donations page.
Dr. Arash Asher:
Cedar-Sinai’s Dr. Arash Asher leads an emerging movement in cancer care. As director of Cancer Survivorship and Rehabilitation at The Samuel Oschin Comprehensive Cancer Institute, he runs a dynamic clinic for patients and survivors.
“Americans afflicted with this disease are living longer than ever and their outlook continues to improve,” says Dr. Asher. Cancer survivors have tripled over the past 30 years, now numbering 12 million.
Dr. Asher’s clinic supports patients and survivors facing a wide range of challenges such as fatigue, weakness, changes in thinking, and pain. “I speak for everyone on our multidisciplinary staff when I say we are committed to helping our patients live life to the fullest,” he says.
In pursuit of that goal, Dr. Asher has integrated a number of innovative cancer rehabilitation programs, including art therapy, personalized exercise regimes, and novel cognitive rehabilitation for “chemobrain.”
Dr. Michael Myers:
A graduate of the Albert Einstein College of Medicine in New York, Dr. Myers established a private practice in general/family medicine in 1978 in his native California. In 1980, he saw the significant impact the emerging obesity epidemic was having on his patients leading to diabetes, fatty liver disease, hypertension, elevated lipids, sleep apnea, and other medical complications. This led him to focus his medical talents to actively treating obesity so as to improve the complicating co-morbidities. He researched methods to increase satiety (“fullness”) in order to address one of the limitations of weight management approaches, leading to a U.S. and foreign patents in 2015 to improve the efficacy of weight loss products.
Dr. Myers interests and work with very-long-chain omega-3 fatty acids dates back almost 20 years, encouraging their use for their medical benefits.
Although retired from medical practice in 2014 because of cancer-related complications, he has now recovered sufficiently to once again actively use his medical talents.
Now, as a “senior citizen,” Dr. Myers can be found on the slopes snowboarding in winter and waterskiing in summer.