Coronavirus disease-2019 (COVID-19) is associated with severe inflammation in mainly the lung, and kidney. Reports suggest a beneficial effect of the use of heparin/low molecular weight heparin (LMWH) on mortality in COVID-19. In part, this beneficial effect could be explained by the anticoagulant properties of heparin/LMWH. Here, we summarise potential beneficial, non-anticoagulant mechanisms underlying treatment of COVID-19 patients with heparin/LMWH, which include: (i) Inhibition of heparanase activity, responsible for endothelial leakage; (ii) Neutralisation of chemokines, and cytokines; (iii) Interference with leukocyte trafficking; (iv) Reducing viral cellular entry, and (v) Neutralisation of extracellular cytotoxic histones. Considering the multiple inflammatory and pathogenic mechanisms targeted by heparin/LMWH, it is warranted to conduct clinical studies that evaluate therapeutic doses of heparin/LMWH in COVID-19 patients. In addition, identification of specific heparin-derived sequences that are functional in targeting non-anticoagulant mechanisms may have even higher therapeutic potential for COVID-19 patients, and patients suffering from other inflammatory diseases.
【저자키워드】 COVID-19, Inflammation, SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2, heparin, SARS-CoV, severe acute respiratory syndrome coronavirus, MERS-CoV, Middle East respiratory syndrome coronavirus, ARDS, acute respiratory distress syndrome, ICU, Intensive care unit, COVID-19, coronavirus disease-2019, low molecular weight heparin, Heparanase, LMWH, low molecular weight heparin, AKI, acute kidney injury, GAGs, glycosaminoglycans, IU, international unit, HPSE, heparanase, HS, heparan sulphate, SGP, spike glycoprotein, NETs, neutrophil extracellular traps, 【초록키워드】 Treatment, Inflammatory diseases, Mortality, lung, chemokines, inhibition, kidney, Patient, pathogenic mechanism, mechanism, COVID-19 patients, Anticoagulant, clinical study, Inflammatory, COVID-19 patient, Interference, therapeutic dose, leukocyte, endothelial, Histones, therapeutic potential, sequence, report, severe inflammation, LMWH, molecular weight, Extracellular, responsible, evaluate, addition, functional, explained, viral cellular entry, 【제목키워드】 Treatment, mechanism, COVID-19 patient,