The prostaglandins produced by cyclooxygenase decrease blood pressure and both prevent and cause inflammation, as it has different receptors (E1-E4). Prostaglandins also increase the presence of neutrophils, which results in inflammation, as well as macrophages. In relation to inflammation, prostaglandins increase the presence of cytokines, as seen in those with COVID-19. Prostaglandins negatively impact the T-cells’ Th1 response, while increasing Th2 response, resulting in lack of protection against the viruses. In a study done on animals, those with influenza A experienced an increase in virus replication due to the formation of prostaglandins. However, prostaglandins decrease the risk of asthma through the decreased leukotriene production.

Prostaglandins and its possible negative impact in relation to COVID-19

Corticosteroids suppress the immune system by inhibiting proinflammatory genes that produce cytokines. They also lessen COX-2 functioning, which prevents prostaglandins from forming. However, when non-steroidal anti-inflammatory drugs block ARA action, involved in the formation of prostaglandins, blood vessels become constricted. This, in turn, results in increased expression of ACE2 receptors in the lungs and other organs, thus increasing the chances of getting COVID-19. Yet, there is still more information needed on non-steroidal anti-inflammatory drugs, such as Ibuprofen. Aspirin, however, has a different impact; it decreases the presence of prostaglandins and increases the presence of leukotrienes and lipoxins, preventing inflammation.

Corticosteroids in relation to COVID-19

A study where participants were given fish oil for 12 weeks showed an increase in EPA and DHA and a decrease in the concentration of omega-6 to omega-3. Thus, EPA and DHA lessen ARA production, preventing synthesis of eicosanoids.  This also means that omega-3’s concentration is greater (responsible for reducing inflammation). EPA and DHA prevent inflammation by inhibiting leukocyte chemotaxis, increasing action of transcription factors that prevent inflammation, etc. The COX and LOX pathways are used to get rid of inflammation by the resolvins from EPA and protections from DHA. The entrance of neutrophils and cytokines into the endothelial tissue is inhibited. In COVID-19 patients, those given fish oil showed a decrease in cytokine levels.

EPA and DHA (forms of omega-3) in relation to COVID-19

ARA is released by the enzyme PLA2, which is oxidized by lipoxygenases, epoxygenase, and cyclooxygenase. 
*Enzymes in figure are elaborated on in the relation nodes

Michigan State University

Polyunsaturated fats (PUFAs) are involved in providing structure to the membranes of phospholipids, as well as membrane fluidity. They also play a role in the expression of genes and serve as substrates for lipids (eicosanoids). Eicosanoids that come from EPA don’t cause as much inflammation as those that come from ARA. However, T-cells contain greater amounts of ARA.

Polyunsaturated fats and its effect on COVID-19 

Rogero, M. M., Leão, M. D. C., Santana, T. M., de MB Pimentel, M. V., Carlini, G. C., da Silveira, T. F., ... & Castro, I. A. (2020). Potential benefits and risks of omega-3 fatty acids supplementation to patients with COVID-19. Free Radical Biology and Medicine.

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