背景:长期COVID(或COVID-19后)的精神症状的早期预防和管理对于减少长期残疾至关重要。现有的临床指南推荐使用ω-3多不饱和脂肪酸(PUFA)作为用于各种常见精神疾病的有希望的治疗方法,因为它们具有抗炎和神经保护特性。这项研究旨在调查omega-3PUFA在减轻COVID-19后精神后遗症方面的潜在功效。
方法:这项为期1年的回顾性队列研究使用TriNetX电子健康记录网络来检查omega-3PUFA补充剂对被诊断为COVID-19的成年人的精神后遗症的影响。使用倾向得分匹配,该研究比较了使用omega-3PUFA补充剂的人和不使用omega-3PUFA的人,评估结果,包括抑郁症,焦虑症,失眠,和其他躯体疾病在COVID-19诊断后一年内。
结果:在接受omega-3PUFA补充剂的16,962名患者和未接受omega-3PUFA补充剂的2,248,803名患者中,补充欧米茄-3显著降低了COVID-19诊断后出现精神后遗症的风险(HR,0.804;95%CI,0.729至0.888)。具体来说,抑郁症的风险(HR,0.828;95%CI,0.714至0.960),焦虑症(HR,0.833;95%CI,0.743至0.933),和失眠(HR,0.679;95%CI,0.531至0.869)在ω-3组中降低。这种效果在不同性别之间是一致的,种族,18-59岁年龄组,以及COVID-19疫苗剂量少于两剂的患者。Omega-3组咳嗽和肌痛的风险也较低,但其他症状如胸痛没有显著差异,呼吸异常,腹部问题,疲劳,头痛,和认知症状。
结论:在安慰剂对照临床试验中,Omega-3PUFA可能需要重新评估,作为预防COVID-19后不良心理健康结局的预防策略。
BACKGROUND: Early prevention and management of
psychiatric symptoms in long COVID (or post-COVID-19 conditions) are crucial for reducing long-term disability. Existing clinical guidelines recommend the use of omega-3 polyunsaturated fatty acids (PUFAs) as a promising therapeutic approach for various common
psychiatric disorders due to their anti-inflammatory and neuroprotective characteristics. This study aims to investigate the potential efficacy of omega-3 PUFAs in alleviating the
psychiatric sequelae following COVID-19.
METHODS: This 1-year retrospective cohort study used the TriNetX electronic health records network to examine the effects of omega-3 PUFAs supplements on
psychiatric sequelae in adults diagnosed with COVID-19. Using propensity-score matching, the study compared those who used omega-3 PUFAs supplements with those who did not, assessing outcomes including depression, anxiety disorders, insomnia, and other somatic conditions up to a year after COVID-19 diagnosis.
RESULTS: In 16,962 patients who received omega-3 PUFAs supplements and 2,248,803 who did not, omega-3 supplementation significantly reduced the risk of developing
psychiatric sequelae post-COVID-19 diagnosis (HR, 0.804; 95% CI, 0.729 to 0.888). Specifically, the risks for depression (HR, 0.828; 95% CI, 0.714 to 0.960), anxiety disorders (HR, 0.833; 95% CI, 0.743 to 0.933), and insomnia (HR, 0.679; 95% CI, 0.531 to 0.869) were reduced in the omega-3 group. This effect was consistent across sex, race, 18-59 age group, and patients with less than two doses of the COVID-19 vaccine. The omega-3 group also had a lower risk of cough and myalgia, but no significant difference was noted for other symptoms like chest pain, abnormal breathing, abdominal issues, fatigue, headache, and cognitive symptoms.
CONCLUSIONS: Omega-3 PUFAs may require re-evaluation as a preventive strategy against adverse mental health outcomes post-COVID-19 in placebo-controlled clinical trials.