FIGURE 1.

The metabolism of the omega-6 (n-6) and omega-3 (n-3) polyunstaurated fatty acids (PUFA) arachidonic acid (AA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The pathways depicted in red indicate proinflammatory mediators during the three stages of COVID-19 severity: early infection (stage 1), pulmonary phase (stage 2), and hyperinflammation phase (stage 3); adapted from Siddiqi and Mehra (2020). Intravenous administration of n-3 PUFA is anticipated to decrease n-6 PUFA and, in particular, AA-derived proinflammatory lipid mediators, and increase specialized pro-resolving mediators (including resolvins of the E- and D-series, protectins, and maresins), as well as the monohydroxy intermediates hydroxy-EPA (HEPE) and the cytochrome P450 epoxides epoxyeicosatrienoic (EET), epoxyeicosatetraenoic (EEQ), and epoxydocosapentaenoic (EDT) acids. Mediators potentially inducing the resolution of inflammation at the different stages of COVID-19 infection (green arrows), are depicted in green.