AUTHOR=Stromberg Sophia , Baxter Bridget A. , Dooley Gregory , LaVergne Stephanie M. , Gallichotte Emily , Dutt Taru , Tipton Madison , Berry Kailey , Haberman Jared , Natter Nicole , Webb Tracy L. , McFann Kim , Henao-Tamayo Marcela , Ebel Greg , Rao Sangeeta , Dunn Julie , Ryan Elizabeth P. 

TITLE=Relationships between plasma fatty acids in adults with mild, moderate, or severe COVID-19 and the development of post-acute sequelae

JOURNAL=Frontiers in Nutrition

VOLUME=9

YEAR=2022

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.960409

DOI=10.3389/fnut.2022.960409

ISSN=2296-861X

ABSTRACT=<sec><title>Background</title><p>SARS-CoV-2 has infected millions across the globe. Many individuals are left with persistent symptoms, termed post-acute sequelae of COVID-19 (PASC), for months after infection. Hyperinflammation in the acute and convalescent stages has emerged as a risk factor for poor disease outcomes, and this may be exacerbated by dietary inadequacies. Specifically, fatty acids are powerful inflammatory mediators and may have a significant role in COVID-19 disease modulation.</p></sec><sec><title>Objective</title><p>The major objective of this project was to pilot an investigation of plasma fatty acid (PFA) levels in adults with COVID-19 and to evaluate associations with disease severity and PASC.</p></sec><sec><title>Methods and procedures</title><p>Plasma from adults with (<italic>N</italic> = 41) and without (<italic>N</italic> = 9) COVID-19 was analyzed by gas chromatography-mass spectrometry (GC-MS) to assess differences between the concentrations of 18 PFA during acute infection (≤14 days post-PCR + diagnosis) in adults with varying disease severity. Participants were grouped based on mild, moderate, and severe disease, alongside the presence of PASC, a condition identified in patients who were followed beyond acute-stage infection (<italic>N</italic> = 23).</p></sec><sec><title>Results</title><p>Significant differences in PFA profiles were observed between individuals who experienced moderate or severe disease compared to those with mild infection or no history of infection. Palmitic acid, a saturated fat, was elevated in adults with severe disease (<italic>p</italic> = 0.04), while behenic (<italic>p</italic> = 0.03) and lignoceric acid (<italic>p</italic> = 0.009) were lower in adults with moderate disease. Lower levels of the unsaturated fatty acids, γ-linolenic acid (GLA) (<italic>p</italic> = 0.03), linoleic (<italic>p</italic> = 0.03), and eicosapentaenoic acid (EPA) (<italic>p</italic> = 0.007), were observed in adults with moderate disease. Oleic acid distinguished adults with moderate disease from severe disease (<italic>p</italic> = 0.04), and this difference was independent of BMI. Early recovery-stage depletion of GLA (<italic>p</italic> = 0.02) and EPA (<italic>p</italic> = 0.0003) was associated with the development of PASC.</p></sec><sec><title>Conclusion</title><p>Pilot findings from this study support the significance of PFA profile alterations during COVID-19 infection and are molecular targets for follow-up attention in larger cohorts. Fatty acids are practical, affordable nutritional targets and may be beneficial for modifying the course of disease after a COVID-19 diagnosis. Moreover, these findings can be particularly important for overweight and obese adults with altered PFA profiles and at higher risk for PASC.</p></sec><sec><title>Clinical trial registration</title><p>[<ext-link ext-link-type="uri" xlink:href="http://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link>], identifier [NCT04603677].</p></sec>