Journal
CARBOHYDRATE POLYMERS
Volume 254, Issue -, Pages -Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.carbpol.2020.117232
Keywords
Heparin; COVID-19; SARS-CoV-2; Anticoagulation; Anti-inflammation; Antivirus
Categories
Funding
- National Natural Science Foundation of China [81901884, 81603037]
- Natural Science Foundation of Hubei Province [2019CFB490]
- Swedish Research Council [2020-05759]
- Swedish Research Council [2020-05759] Funding Source: Swedish Research Council
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Heparin may have multiple effects in managing COVID-19, including anticoagulant, anti-inflammatory, and direct antiviral activities. However, challenges and adverse effects of using heparin therapy for SARS-CoV-2 infection need to be considered.
The pandemic coronavirus disease 2019 (COVID-19), caused by the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly spreading globally. Clinical observations found that systemic symptoms caused by SARS-CoV-2 infection are attenuated when using the anticoagulant agent heparin, indicating that heparin may play other roles in managing COVID-19, in addition to prevention of pulmonary thrombosis. Several biochemical studies show strong binding of heparin and heparin-like molecules to the Spike protein, which resulted in inhibition of viral infection to cells. The clinical observations and in vitro studies argue for a potential multiple-targeting effects of heparin. However, adverse effects of heparin administration and some of the challenges using heparin therapy for SARS-CoV-2 infection need to be considered. This review discusses the pharmacological mechanisms of heparin regarding its anticoagulant, anti-inflammatory and direct antiviral activities, providing current evidence concerning the effectiveness and safety of heparin therapy for this major public health emergency.
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