{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:11:35Z","timestamp":1753891895417,"version":"3.41.2"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T00:00:00Z","timestamp":1745280000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004484","name":"Tehran University of Medical Sciences and Health Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004484","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The global impact of Coronavirus Disease 2019 (COVID-19 (has highlighted the necessity of understanding factors influencing its severity and hospitalization duration. While a balanced diet is crucial for immune support, the role of dietary fats in this context has not been well understood. This study explored associations between the quality and quantity of fatty acids and severity and the length of hospitalization in COVID-19 patients in 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This cross-sectional study included 107 COVID-19 patients aged 20\u201360 years who were hospitalized at Amir Alam Hospital in Tehran, Iran. Dietary fat intake was assessed using 24 h food recall. Data on symptoms were collected using a demographic questionnaire and verified against their hospital records. Linear and binary logistic regressions were employed for statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>A higher omega 6\/omega 3(N6\/N3) ratio was linked to increased odds of respiratory distress syndrome (RDS) and elevated D-dimer levels, while correlating with lower odds of fever. While RDS odds increased over Vit E\/polyunsaturated fatty acid (PUFA) ratio tertiles, chills decreased. [PUFA + monounsaturated fatty acid (MUFA)]\/saturated fatty acid (SFA) ratio was associated with reduced odds of chest pain, duration of hospitalization (DH) time, c-reactive protein (CRP), and D-dimer levels. Furthermore, PUFA intake was negatively associated with odds of poor appetite, RDS, and headaches, whereas SFA intake was positively associated with odds of fever. Additionally, there was a positive correlation between cholesterol-saturated index (CSI) levels and DH time (<jats:italic>P<\/jats:italic> &amp;lt; 0.7).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings indicate that higher N6\/N3 and VitE\/PUFA ratios were associated with increased RDS and D-dimer levels, while the VitE\/PUFA ratio was linked to reduced chills. Higher (PUFA + MUFA)\/SFA ratios were associated with lower chest pain, DH, CRP, and D-dimer levels. While higher PUFA intake was related to reduced poor appetite, RDS, and headache, higher SFA intake was linked to increased fever. Additionally, there was a positive association between CSI levels and DH. Current findings indicate that the quality and balance of dietary fats may play a crucial role in modulating inflammatory responses and clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnut.2025.1551760","type":"journal-article","created":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T04:10:19Z","timestamp":1745295019000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between dietary fat quality and quantity and hospitalization duration in COVID-19 in Iranian patients: a cross-sectional study"],"prefix":"10.3389","volume":"12","author":[{"given":"Farideh","family":"Shiraseb","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atieh","family":"Mirzababaei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahya","family":"Mehri Hajmir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Ebrahimi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shabnam","family":"Hosseini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeinab","family":"Zarrinvafa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahnaz","family":"Sadid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasaman","family":"Aali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azam","family":"Mohamadi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khadijeh","family":"Mirzaei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,22]]},"reference":[{"key":"B1","unstructured":"Coronavirus Disease (COVID-19) Pandemic.\n          \n          2020"},{"key":"B2","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1016\/S2213-2600(21)00218-6","article-title":"The COVID-19 puzzle: deciphering pathophysiology and phenotypes of a new disease entity","volume":"9","author":"Osuchowski","year":"2021","journal-title":"Lancet Respir Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1038\/s41392-021-00527-1","article-title":"COVID-19 in early 2021: current status and looking forward","volume":"6","author":"Wang","year":"2021","journal-title":"Signal Transduct Target Ther"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e22717","DOI":"10.2196\/22717","article-title":"Diet, nutrition, obesity, and their implications for COVID-19 mortality: development of a marginalized two-part model for semicontinuous data","volume":"7","author":"Kamyari","year":"2021","journal-title":"JMIR Public Health Surveill."},{"key":"B5","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.bbi.2020.04.040","article-title":"The impact of nutrition on COVID-19 susceptibility and long-term consequences","volume":"87","author":"Butler","year":"2020","journal-title":"Brain Behav Immun."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2052","DOI":"10.1001\/jama.2020.6775","article-title":"Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York city area","volume":"323","author":"Richardson","year":"2020","journal-title":"JAMA."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1016\/S0140-6736(86)91384-X","article-title":"The cholesterol\/saturated-fat index: an indication of the hypercholesterolaemic and atherogenic potential of food","volume":"1","author":"Connor","year":"1986","journal-title":"Lancet."},{"key":"B8","first-page":"133","article-title":"Nutrition, immune function, and infectious disease","author":"Smith","year":"2021","journal-title":"Med J"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/nu12061562","article-title":"Strengthening the immune system and reducing inflammation and oxidative stress through diet and nutrition: considerations during the COVID-19 crisis","author":"Iddir","year":"","journal-title":"Nutrients."},{"key":"B10","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1024\/0300-9831.70.2.31","article-title":"Relationship between vitamin E requirement and polyunsaturated fatty acid intake in man: a review","volume":"70","author":"Valk","year":"2000","journal-title":"Int J Vitam Nutr Res."},{"key":"B11","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/s12916-018-1113-8","article-title":"Validity of an online 24-h recall tool (myfood24) for dietary assessment in population studies: comparison with biomarkers and standard interviews","volume":"16","author":"Wark","year":"2018","journal-title":"BMC Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1161\/CIR.0000000000000510","article-title":"Dietary fats and cardiovascular disease: a presidential advisory from the American heart association","volume":"136","author":"Sacks","year":"2017","journal-title":"Circulation"},{"key":"B13","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1016\/s0753-3322(02)00253-6","article-title":"The importance of the ratio of omega-6\/omega-3 essential fatty acids","volume":"56","author":"Simopoulos","year":"2002","journal-title":"Biomed Pharmacother."},{"key":"B14","doi-asserted-by":"publisher","first-page":"963471","DOI":"10.3389\/fnut.2022.963471","article-title":"Saturated fatty acid biomarkers and risk of cardiometabolic diseases: a meta-analysis of prospective studies","volume":"9","author":"Li","year":"2022","journal-title":"Front Nutr."},{"key":"B15","doi-asserted-by":"publisher","first-page":"304","DOI":"10.3390\/jcm12010304","article-title":"Omega-3 polyunsaturated fatty acids (n-3 PUFAs) for immunomodulation in COVID-19 related acute respiratory distress syndrome (ARDS)","volume":"12","author":"Velotti","year":"2022","journal-title":"J Clin Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.biochi.2020.09.003","article-title":"May omega-3 fatty acid dietary supplementation help reduce severe complications in Covid-19 patients?","volume":"179","author":"Weill","year":"2020","journal-title":"Biochimie"},{"key":"B17","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.ejccm.2013.11.002","article-title":"Impact of oral omega-3 fatty acids supplementation in early sepsis on clinical outcome and immunomodulation","volume":"1","author":"Hosny","year":"2013","journal-title":"Egypt J Crit Care Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"107553","DOI":"10.1016\/j.jdiacomp.2020.107553","article-title":"Fish oil reduces subclinical inflammation, insulin resistance, and atherogenic factors in overweight\/obese type 2 diabetes mellitus patients: a pre-post pilot study","volume":"34","author":"de Souza","year":"2020","journal-title":"J Diabetes Complications."},{"key":"B19","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1186\/s12967-022-03604-3","article-title":"Effect of Omega-3 fatty acids supplementation on serum level of C-reactive protein in patients with COVID-19: a systematic review and meta-analysis of randomized controlled trials","volume":"20","author":"Taha","year":"2022","journal-title":"J Transl Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1017\/S0007114521003214","article-title":"The relationship between dietary inflammatory index and disease severity and inflammatory status: a case\u2013control study of COVID-19 patients","volume":"127","author":"Moludi","year":"2022","journal-title":"Br J Nutr."},{"key":"B21","doi-asserted-by":"publisher","first-page":"227","DOI":"10.3390\/medicina59020227","article-title":"Adherence to the mediterranean diet association with serum inflammatory factors stress oxidative and appetite in COVID-19 patients","volume":"59","author":"Mohajeri","year":"2023","journal-title":"Medicina."},{"key":"B22","doi-asserted-by":"publisher","first-page":"923746","DOI":"10.3389\/fmed.2022.923746","article-title":"Circulating polyunsaturated fatty acids and COVID-19: a prospective cohort study and mendelian randomization analysis","volume":"9","author":"Sun","year":"2022","journal-title":"Front Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"2582","DOI":"10.3390\/nu14122582","article-title":"The inverse association between omega-3 index and COVID-19 severity: A case-control study","volume":"14","author":"Ramezani","year":"2022","journal-title":"Nutrients"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1410154","DOI":"10.3389\/fnut.2024.1410154","article-title":"Associations of \u03c9-3, \u03c9-6 polyunsaturated fatty acids intake and \u03c9-6: \u03c9-3 ratio with systemic immune and inflammatory biomarkers: NHANES 1999\u20132020","volume":"11","author":"Li","year":"2024","journal-title":"Front Nutr."},{"key":"B25","doi-asserted-by":"publisher","first-page":"e14854","DOI":"10.1111\/ijcp.14854","article-title":"Omega-3 polyunsaturated fatty acids supplementation improve clinical symptoms in patients with Covid-19: a randomised clinical trial","volume":"75","author":"Sedighiyan","year":"2021","journal-title":"Int J Clin Pract."},{"key":"B26","doi-asserted-by":"publisher","first-page":"6520","DOI":"10.3390\/nu7085294","article-title":"Effects of a low dose of fish oil on inflammatory markers of brazilian HIV-infected adults on antiretroviral therapy: a randomized, parallel, placebo-controlled trial","volume":"7","author":"Oliveira","year":"2015","journal-title":"Nutrients"},{"key":"B27","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1111\/joim.12442","article-title":"Fish oil supplementation does not lower C-reactive protein or interleukin-6 levels in healthy adults","volume":"279","author":"Muldoon","year":"2016","journal-title":"J Intern Med"},{"key":"B28","doi-asserted-by":"publisher","first-page":"929384","DOI":"10.3389\/fnut.2022.929384","article-title":"Major dietary patterns in relation to disease severity, symptoms, and inflammatory markers in patients recovered from COVID-19","volume":"9","author":"Ebrahimzadeh","year":"2022","journal-title":"Front Nutr."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2147\/JIR.S229691","article-title":"Saturated fatty acids in obesity-associated inflammation","volume":"13","author":"Zhou","year":"2020","journal-title":"J Inflamm Res"},{"key":"B30","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1186\/s13075-015-0784-1","article-title":"Fatigue in chronic inflammation-a link to pain pathways","volume":"17","author":"Louati","year":"2015","journal-title":"Arthritis Res Ther"},{"key":"B31","doi-asserted-by":"publisher","first-page":"330","DOI":"10.3390\/ijms22010330","article-title":"Monounsaturated fatty acids in obesity-related inflammation","volume":"22","author":"Ravaut","year":"2020","journal-title":"Int J Mol Sci."},{"key":"B32","doi-asserted-by":"publisher","first-page":"e2021049","DOI":"10.23750\/abm.v92i2.9235","article-title":"The role of serum monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) in cardiovascular disease risk","volume":"92","author":"Kharazmi-Khorassani","year":"2021","journal-title":"Acta Biomed"},{"key":"B33","doi-asserted-by":"publisher","first-page":"755","DOI":"10.20452\/pamw.4376","article-title":"Potential contribution of monounsaturated fatty acids to cardiovascular risk in chronic kidney disease","volume":"128","author":"Mika","year":"2018","journal-title":"Pol Arch Intern Med"},{"key":"B34","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1007\/s43450-021-00213-x","article-title":"Assessment of polyunsaturated fatty acids on COVID-19-associated risk reduction","volume":"32","author":"Baral","year":"2022","journal-title":"Rev Bras Farmacogn."},{"key":"B35","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1042\/BST0330423","article-title":"Polyunsaturated fatty acids and inflammation","volume":"33","author":"Calder","year":"2005","journal-title":"Biochem Soc Trans"},{"key":"B36","doi-asserted-by":"publisher","first-page":"529","DOI":"10.4103\/sja.SJA_50_18","article-title":"Enteral nutrition with omega-3 fatty acids in critically ill septic patients: a randomized double-blinded study","volume":"12","author":"Ibrahim","year":"2018","journal-title":"Saudi J Anaesth."},{"key":"B37","doi-asserted-by":"publisher","first-page":"355","DOI":"10.3390\/nu2030355","article-title":"Omega-3 fatty acids and inflammatory processes","volume":"2","author":"Calder","year":"2010","journal-title":"Nutrients."},{"key":"B38","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1093\/intimm\/dxz001","article-title":"Omega-3 fatty acid-derived mediators that control inflammation and tissue homeostasis","volume":"31","author":"Ishihara","year":"2019","journal-title":"Int Immunol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"FF05","DOI":"10.7860\/JCDR\/2017\/25036.9596","article-title":"Effect of sodium valproate and docosahexaenoic acid on pain in rats","volume":"11","author":"Kunder","year":"2017","journal-title":"J Clin Diagn Res"},{"key":"B40","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1007\/s11910-016-0693-1","article-title":"Dietary triggers of migraine","volume":"16","author":"Zaeem","year":"2016","journal-title":"Curr Neurol Neurosci Rep."},{"key":"B41","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1080\/1028415X.2016.1266133","article-title":"A double-blind, randomized, and placebo-controlled clinical trial with omega-3 polyunsaturated fatty acids (OPFA \u03c9-3) for the prevention of migraine in chronic migraine patients using amitriptyline","volume":"21","author":"Soares","year":"2018","journal-title":"Nutr Neurosci."},{"key":"B42","doi-asserted-by":"publisher","first-page":"18820","DOI":"10.1073\/pnas.0905415106","article-title":"Activation of TRPV1 in the spinal cord by oxidized linoleic acid metabolites contributes to inflammatory hyperalgesia","volume":"106","author":"Patwardhan","year":"2009","journal-title":"Proc Natl Acad Sci U.S.A."}],"container-title":["Frontiers in Nutrition"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1551760\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,22]],"date-time":"2025-04-22T04:10:23Z","timestamp":1745295023000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnut.2025.1551760\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,22]]},"references-count":42,"alternative-id":["10.3389\/fnut.2025.1551760"],"URL":"https:\/\/doi.org\/10.3389\/fnut.2025.1551760","relation":{},"ISSN":["2296-861X"],"issn-type":[{"type":"electronic","value":"2296-861X"}],"subject":[],"published":{"date-parts":[[2025,4,22]]},"article-number":"1551760"}}