Omega-3 polyunsaturated fatty acids supplementation improve clinical symptoms in patients with Covid-19: A randomised clinical trial.

AIMS: We hypothesised that omega-3 fatty acids would be an appropriate adjunct therapy for alleviating the inflammatory response and clinical manifestation in hospitalised patients with Covid-19 disease. METHODS: This was a single-blind randomised controlled trial in Amir-Alam hospital in Tehran. Thirty adult men and women diagnosed with Covid-19 were allocated to either control group (receiving Hydroxychloroquine) or intervention group (receiving Hydroxychloroquine plus 2 grams of Docosahexaenoic acid [DHA] + Eicosapentaenoic acid [EPA]) for 2 weeks. Primary outcome of the intervention including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) as well as clinical symptoms including body pain, fatigue, appetite and olfactory and secondary outcomes including liver enzymes were determined at the baseline and after omega-3 supplementation. Clinical signs were measured using self-reported questionnaires. There were commercial kits for determination of CRP and liver enzymes concentrations in the serum of patients. For determination of ESR automated haematology analyser was applied. The study of "Comparison of the effectiveness of omega-3 and Hydroxychloroquine on Inflammatory factors, liver enzymes and clinical symptoms in diabetic Covid-19 patients" was registered in Iranian Registry of Clinical Trials (IRCT) with ID number: IRCT20200511047399N1. RESULTS: In comparison to control group, patients receiving omega-3 indicated favourable changes in all clinical symptoms except for olfactory (P < .001 for body pain and fatigue, P = .03 for appetite and P = .21 for olfactory). Reducing effects of omega-3 supplementation compared with control group were also observed in the levels of ESR and CRP after treatment (P < .001 for CRP and P = .02 for ESR). However, no between group differences in the liver enzymes serum concentrations were observed after supplementation (P > .05). CONCLUSION: Current observations are very promising and indicate that supplementation with moderate dosages of omega-3 fatty acids may be beneficial in the management of inflammation-mediated clinical symptoms in Covid-19 patients.

Inflammatory cytokines and sarcopenia in Iranian adults-results from SARIR study.

Some studies suggested the effects of inflammatory cytokines in reducing muscle mass and muscle strength and, performance. This study aimed to compare pro-inflammatory cytokines in sarcopenic and non-sarcopenic subjects. 120 men and women were selected out from the cross-sectional study 'sarcopenia and its determinants among Iranian elders' (SARIR). Sarcopenia was defined based on the first 'European Working Group on sarcopenia in older people' (EWGSOP1) guidelines. A fasting blood sample was taken from each participant to measure serum high-sensitivity C-reactive protein (hs-CRP), Interleukin 6 (IL-6), and tumor necrosis factor α (TNFα). A total of 120 participants were included in this study. Mean age was 66.7 ± 7.7 years and mean body mass index (BMI) was 27.3 ± 4.2 kg/m2. Forty participants had the criteria of EWGSOP1 sarcopenia. A statistically significant difference was seen between normal and abnormal groups of muscle strength in hs-CRP (P-value = 0.04). Furthermore, we did not observe any remarkable association between inflammatory biomarkers including IL-6 (OR 1.15; 95% CI 0.31-4.28), TNF-α (OR 0.68; 95% CI 0.17-2.77), and hs-CRP (OR 2.39; 95% CI 0.87-6.55) and the presence of sarcopenia even after controlling for plausible confounders. We found that inflammatory biomarkers level was not associated with odds of sarcopenia. The lack of correlation between inflammatory cytokines and sarcopenia could be due to the participants' age and genetics. Future studies are required to confirm these findings.

Post-stroke Cognitive Impairment and Malnutrition in the Elderly (PCIME): study design and protocol.

PURPOSE: Stroke and dementia are burdensome non communicable diseases but preventable. A joint prevention of stroke and dementia requires a comprehensive approach by controlling common risk factors. Little is known about the role of malnutrition in post-stroke cognitive impairments. The main aim of this study is to evaluate the presence of cognitive impairment after stroke and its association with malnutrition. METHODS: Post-stroke Cognitive Impairment and Malnutrition in the Elderly (PCIME) is a prospective hospital-based cohort study, started on January 2nd, 2018 at Ziaeian Hospital, a referral center for elderly, Tehran, Iran, Middle East. We have used a battery of neuropsychiatric tests, including the Montreal Cognitive Assessment and Mini-Mental State Examination. We have assessed malnutrition using the Mini Nutritional Assessment and Geriatric Nutritional Risk Index. CONCLUSION: PCIME will enable us to assess the role of malnutrition in development of post stroke dementia. This study will help clinicians and researchers develop preventive measures to reduce the burden of stroke and dementia.

Pain: The Neglect Issue in Old People's Life.

BACKGROUND: As the elderly population increases dramatically, the chronic age-related disease should be noted. In the elderly, chronic pain is a common health problem. METHODS: This search was performed in 3 databases (PubMed, Google Scholar, Embase). We have reviewed articles related to pain management in the elderly. RESULT: The prevalence of pain in people aged above 60 is twice that in younger people. Pain is estimated to be 45-85 per cent in the elderly. Pain is not a part of the ageing process, but many older people can experience it. Perception of pain can be affected by environmental, emotional, cultural and cognitive factors. Pain in the elderly often remains untreated and misdiagnosed. CONCLUSION: Pain management in elderly needs different approach because of unreported pain in this population, and usually they have multiple problems and comorbidities that complicate evaluation and treatment.