COVID-19 Tanılı Yoğun Bakım Hastalarında Omega-3 Çoklu Doymamış Yağ Asitleri Desteğinin Etkileri

SARS-CoV-2 adı ile ilk kez bildirilen ve COVID-19 olarak adlandırılan yeni tip koronavirüsün neden olduğu salgın hastalıkkısa sürede yayılım göstererek küresel bir sağlık sorunu haline gelmiş ve Dünya Sağlık Örgütü salgını bir pandemi olaraknitelendirmiştir. COVID-19 hastalığının yönetimi için önerilen spesifik bir antiviral tedavi bulunmamaktadır. Hastalardaimmün yanıtı hedefleyen ve sitokin fırtınasını azaltmaya yönelik alternatif tedavi yöntemlerinin geliştirilmesi, hastalığayanıtın iyileştirilmesinde önemli bir stratejidir. Hastalıktan korunmada ve hastalığın yönetimi sürecinde konağın bağışıklıksisteminin güçlendirilmesini hedefleyen stratejiler, virüsle savaşmada ve hastalık etkisinin azaltılmasında önemlidir. Balıkyağı kaynaklı Eikozapentaenoik Asit (EPA) ve Dokozahekzaenoik Asit (DHA) biyolojik olarak güçlü özellik taşır. Omega-3Çoklu Doymamış Yağ Asitleri (PUFA) güçlü immünmodülatör aktiviteye sahip olup, diyetin balık yağı ile zenginleştirilmesimonosit ve nötrofil kemotaksisinde azalmaya neden olur, proinflamatuvar sitokin üretimini azaltır ve antiinflamatuvaretkiler gösterir. Kritik hastalarda yapılan çalışmalar, enteral ve parenteral omega-3 PUFA takviyelerinin sitokin üretiminiazalttığını göstermiştir. Sitokinler üzerindeki bu etkileri nedeni ile omega-3 PUFA, akut ve kronik inflamasyon durumlarındave uygunsuz şekilde aktive edilmiş olan immün yanıtın azaltılmasında kullanılmaktadır. COVID-19 hastalığının yönetimi ileilgili yayınlanan beslenme kılavuzları, balık yağı kullanımının hastalığın yönetiminde potansiyel yararlı etkileri olabileceğinibildirmiştir. Bu derleme yazıda, COVID-19 ile omega-3 PUFA arasındaki ilişki incelenmiş ve COVID-19 hastaları için omega-3PUFA’ların önemi ele alınmıştır.

Effects of Omega-3 Polyunsaturated Fatty Acids Supplementation in Intensive Care Patients with COVID-19

The epidemic caused by the new type of coronavirus, which was first reported as SARS-CoV-2 and called COVID-19, spread in a short time and became a global health problem and the World Health Organization described the epidemic as a pandemic. There is no specific antiviral therapy recommended for the management of COVID-19 disease. Developing alternative treatment methods that target immune response and reduce cytokine storm in patients is an important strategy in improving disease response. Strategies that aim to strengthen the immune system of the host in the prevention and management of the disease are important in fighting the virus and reducing the effect of the disease. Eicosapentaenoic Acid (EPA) and Docosahexaenoic Acid (DHA) from fish oil are biologically strong. Omega-3 Polyunsaturated Fatty Acids (PUFAs) have strong immunomodulatory activity, and enrichment of the diet with fish oil causes a decrease in monocyte and neutrophil chemotaxis, decreases proinflammatory cytokine production and exhibits anti-inflammatory effects. Studies in critically ill patients have shown that enteral and parenteral omega-3 supplements reduce cytokine production. Because of these effects on cytokines, omega-3 PUFA is used in acute and chronic inflammation situations and in reducing the immune response that is inappropriately activated. Published dietary guidelines on the management of COVID-19 disease have reported that the use of fish oil can have potential beneficial effects in the management of the disease. In this review, the association between COVID-19 and omega-3 PUFAs was investigated and the importance of omega-3 PUFAs for patients with COVID-19 was discussed.

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