Habitual fish oil use and risk of COVID-19-related outcomes: Evidence from a large scale cohort study and Mendelian randomization analysis

Yuying Ma; Lijun Zhang; Ruijie Zeng; Rui Jiang; Dongling Luo; Huihuan Wu; Zewei Zhuo; Qi Yang; Jingwei Li; Felix W Leung; Chongyang Duan; Weihong Sha; Hao Chen

doi:10.1016/j.clnu.2023.07.001

Habitual fish oil use and risk of COVID-19-related outcomes: Evidence from a large scale cohort study and Mendelian randomization analysis

Clin Nutr. 2023 Aug;42(8):1399-1407. doi: 10.1016/j.clnu.2023.07.001. Epub 2023 Jul 6.

Authors

Yuying Ma¹, Lijun Zhang², Ruijie Zeng³, Rui Jiang², Dongling Luo⁴, Huihuan Wu², Zewei Zhuo⁵, Qi Yang⁵, Jingwei Li¹, Felix W Leung⁶, Chongyang Duan⁷, Weihong Sha⁸, Hao Chen⁹

Affiliations

¹ Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China.
² Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; School of Medicine, South China University of Technology, Guangzhou 510006, China.
³ Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; Shantou University Medical College, Shantou 515000, Guangdong, China.
⁴ Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
⁵ Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China.
⁶ David Geffen School of Medicine, University of California Los Angeles, Los Angeles 90024, California, USA; Sepulveda Ambulatory Care Center, Veterans Affairs Greater Los Angeles Healthcare System, North Hills 91343, California, USA. Electronic address: [email protected].
⁷ Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou 510515, China. Electronic address: [email protected].
⁸ Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China; School of Medicine, South China University of Technology, Guangzhou 510006, China; Shantou University Medical College, Shantou 515000, Guangdong, China. Electronic address: [email protected].
⁹ Department of Gastroenterology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China; School of Medicine, South China University of Technology, Guangzhou 510006, China; Shantou University Medical College, Shantou 515000, Guangdong, China. Electronic address: [email protected].

PMID: 37429103
DOI: 10.1016/j.clnu.2023.07.001

Abstract

Background & aims: Previous findings for the effects of fish oil on COVID-19-related outcomes remain largely inconclusive and controversy persists. Large population-based studies in real-life settings are required to explore the impact of habitual fish oil use on Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, Coronavirus disease 2019 (COVID-19)-related hospitalization and death. To investigate the associations between habitual fish oil use and SARS-CoV-2infection, COVID-19-related outcome.

Methods: Cohort study based on the UK Biobank. 466,572 participants were enrolled. For Mendelian randomization (MR) study, single-nucleotide variants were selected for exposures of fish-oil-derived n-3 PUFAs, including docosapentaenoic acid (DPA).

Results: 146,969 (31.5%) participants reported their habitual fish oil use at baseline. Compared with non-fish-oil-users, the hazard ratios for habitual users were 0.97 (95% confidence interval [CI] 0.94 to 0.99) for SARS-CoV-2 infection, 0.92 (95% CI 0.85 to 0.98) for COVID-19-related hospitalization and 0.86 (95% CI 0.75 to 0.98) for COVID-19-related death. MR showed that a higher level of circulating DPA is casually associated with a lower risk of severe COVID-19 (IVW, odds ratio = 0.26, 95% CI 0.08-0.88, P = 0.030).

Conclusions: In this large cohort, we found that habitual fish oil use was significantly associated with lower risks of SARS-CoV-2 infection, hospitalization and death from COVID-19. MR analyses further support a possible causal role of DPA, one of the components of fish oil and valid biomarkers of dietary intake, in reducing the risk of severe COVID-19.

Keywords: COVID-19; Epidemiology; Nutrition; SARS-CoV-2 infection.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19*
Cohort Studies
Fish Oils / therapeutic use
Humans
Mendelian Randomization Analysis
SARS-CoV-2

Substances

Fish Oils