Reports suggest a role of endothelial dysfunction and loss of endothelial barrier function in COVID-19. It is well established that the endothelial glycocalyx-degrading enzyme heparanase contributes to vascular leakage and inflammation. Low molecular weight heparins (LMWH) serve as an inhibitor of heparanase. We hypothesize that heparanase contributes to the pathogenesis of COVID-19, and that heparanase may be inhibited by LMWH. To test this hypothesis, heparanase activity and heparan sulfate levels were measured in plasma of healthy controls (n = 10) and COVID-19 patients (n = 48). Plasma heparanase activity and heparan sulfate levels were significantly elevated in COVID-19 patients. Heparanase activity was associated with disease severity including the need for intensive care, lactate dehydrogenase levels, and creatinine levels. Use of prophylactic LMWH in non-ICU patients was associated with a reduced heparanase activity. Since there is no other clinically applied heparanase inhibitor currently available, therapeutic treatment of COVID-19 patients with low molecular weight heparins should be explored.
【저자키워드】 COVID-19, Inflammation, Heparanase, vascular leakage, LMWH (low molecular weight heparin), glycocalyx damage, 【초록키워드】 intensive care, disease severity, Prophylactic, heparin, lactate dehydrogenase, Endothelial dysfunction, plasma, inhibitor, COVID-19 patients, Hypothesis, creatinine, COVID-19 patient, low molecular weight, endothelial, enzyme, healthy control, pathogenesis of COVID-19, report, LMWH, Therapeutic treatment, molecular weight, significantly, clinically, inhibited, elevated, applied, reduced, contribute, were measured, non-ICU patient, 【제목키워드】 activity, Increased,