Potential benefits and risks of omega-3 fatty acids supplementation to patients with COVID-19.

Studies have shown that infection, excessive coagulation, cytokine storm, leukopenia, lymphopenia, hypoxemia and oxidative stress have also been observed in critically ill Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) patients in addition to the onset symptoms. There are still no approved drugs or vaccines. Dietary supplements could possibly improve the patient's recovery. Omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), present an anti-inflammatory effect that could ameliorate some patients need for intensive care unit (ICU) admission. EPA and DHA replace arachidonic acid (ARA) in the phospholipid membranes. When oxidized by enzymes, EPA and DHA contribute to the synthesis of less inflammatory eicosanoids and specialized pro-resolving lipid mediators (SPMs), such as resolvins, maresins and protectins. This reduces inflammation. In contrast, some studies have reported that EPA and DHA can make cell membranes more susceptible to non-enzymatic oxidation mediated by reactive oxygen species, leading to the formation of potentially toxic oxidation products and increasing the oxidative stress. Although the inflammatory resolution improved by EPA and DHA could contribute to the recovery of patients infected with SARS-CoV-2, Omega-3 fatty acids supplementation cannot be recommended before randomized and controlled trials are carried out.

Efficacy of Jackfruit365™ Green Jackfruit Flour Fortified Diet on Pegfilgrastim to Prevent Chemotherapy-Induced Leukopenia, Irrespective of Tumor Type or Drugs Used-A Retrospective Study.

Chemotherapy-Induced Leukopenia (CIL) is associated with increased mortality and economic burden on patients. This study was conducted to evaluate whether inclusion of green jackfruit flour in regular diet of those patients receiving chemotherapy, could prevent CIL. This was a retrospective study conducted among a group of patients undergoing chemotherapy for solid tumors at Renai Medicity Hospital, Palarivattom, Cochin, Kerala, India, since June 2018. The study group comprised of 50 consecutive subjects, who were supplemented with green jackfruit flour diet in their regular diet and further followed up prospectively. The control group was retrospective with 50 subjects prior to June 2018, with no diet supplements. Those who received less than three cycles were excluded from either arm. The mean age of the participants in study group and control group were 53.16 ± 11.06 and 56.96 ± 12.16 years respectively. In the study group, six patients out of 37, and 20 patients out of 50 in the control group, developed CIL. They received 38 and 105 vials of filgrastim respectively. After excluding those cycles in study group patients, where green jackfruit flour was not taken, the mean number of cycles in which CIL developed (p = 0.00) and number of vials of filgrastim taken per cycle (p = 0.00) were significantly different from control group and no patient in the study group developed CIL. Inclusion of green jackfruit flour as a dietary intervention prevents chemotherapy-induced leukopenia in patients undergoing chemotherapy along with pegfilgrastim.

[Hematological indices of rats having complete and vitamin-deficient diets enriched with dietary fibers].

The hematological indices in 48 rats Wistar male with initial body weight 58.1+/- 0.5g has been studied. The rats were divided into 6 group and fed the complete semi-synthetic diet, containing 100% or 20% of vitamin mixture (Vit) with or without addition of dietary fiber (DF) in the form of wheat bran (5% of diet mass) during 4 weeks. The animals of the 1 group received 100% of vitamin mixture (100% Vit); of the 2 group--100% Vit+DF; 3 group--20% of vitamin mixture (20% Vit); 4 group--20% of vitamin mixture and DF (20% Vit+DF). The next 5 days rats from vitamin-deficient groups were fed with diets supplemented with 80% of Vit: (5 group--20% Vit+ 80% Vit; 6 group--20% Vit+DF+80% Vit). The animals fed vitamin-deficient diet lag significantly in growth from animals fed a complete diet. The growth curve of rats fed a diet with DF took an intermediate position. The studies were carried out at the Hematology analyzer "Coulter AC TTM 5 diff OV" (Beckman Coulter, USA) under the program, developed for the study of rat blood. Mean corpuscular volume (MCV) and mean corpuscular hemoglobin content (MCHC) were significantly decreased in rats with combined vitamin deficiency (20% Vit) in the diet compared with those of control group rats, while the compensatory increase in the number of red blood cells (RBC) and leukocytopenia took place. The enrichment of vitamin-deficient diet with DF (20% Vit+DF) prevented MCV and RBC changes, but MCHC left reduced in comparison with the indicator of the rats in control group. Indicators characterizing the state of platelets had no statistically significant differences between the groups. Compensation of vitamin deficiency in the diet of rats from group 5 (20% Vit+80% Vit) led only to the normalization of MCV. After vitamin restore in the diet of group 6 (20% Vit+DF+80% Vit) all investigated parameters were indistinguishable from the parameters of the control group. This indicates a positive effect of wheat bran DF consumption on the studied hematological indices.

Clinicopathological analysis of hematological disorders in tube-fed patients with copper deficiency.

OBJECT: Anemia and leukopenia caused by copper deficiency are well-documented consequences of long-term total parenteral nutrition. We measured the serum copper levels of bed-ridden patients receiving enteral feeding, and evaluated optical and ultrastructural features of bone marrow before and after copper supplementation. PATIENTS AND METHODS: Serum samples were obtained from 15 bed-ridden elderly patients receiving tube feeding (TF) and 10 age-matched bed-ridden patients who took food orally (CO), and the copper ceruloplasmin concentration of each sample was measured. Bone marrow samples were obtained from patients who exhibited copper deficiency and leukopenia and/or anemia before and after the copper supplementation, for use in light and electron microscopic analysis. RESULTS: The tube-fed patients had significantly lower mean serum copper and ceruloplasmin concentrations than the control patients. Seven of the 15 tube-fed patients had reduced serum copper concentrations and leukopenia. Six of those 7 patients also had anemia. Copper sulfate was administered to those 7 patients by enteral tube; their copper concentration, anemia and leukopenia improved within 1 month after they were administered copper sulfate. In the bone marrow examination before copper supplementation, light microscopy showed cytoplasmic vacuolization in both myeloid and erythroid precursors, and electron microscopy showed electron-dense deposits in mitochondria and cytoplasm of erythroid and myeloid cells. After copper supplementation, these pathological changes disappeared. CONCLUSIONS: Bicytopenia is likely to occur in tube-fed patients with copper deficiency. Copper deficiency appears to be associated with cytoplasmic vacuolization and electron-dense deposits in mitochondria in erythroid and myeloid cells.