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Neutrophil Elastase Inhibitor (Sivelestat) May Be a Promising Therapeutic Option for Management of Acute Lung Injury/Acute Respiratory Distress Syndrome or Disseminated Intravascular Coagulation in Covid-19 Publisher Pubmed



Sahebnasagh A1 ; Saghafi F2 ; Safdari M3 ; Khataminia M4 ; Sadremomtaz A5 ; Talaei Z6 ; Rezai Ghaleno H7 ; Bagheri M8 ; Habtemariam S9 ; Avan R10
Authors

Source: Journal of Clinical Pharmacy and Therapeutics Published:2020


Abstract

What is known and objective: This article summarizes the effects of sivelestat on acute lung injury/acute respiratory distress syndrome (ALI/ARDS) or ARDS with coagulopathy, both of which are frequently seen in patients with COVID-19. Comment: COVID-19 patients are more susceptible to thromboembolic events, including disseminated intravascular coagulation (DIC). Various studies have emphasized the role of neutrophil elastase (NE) in the development of DIC in patients with ARDS and sepsis. It has been shown that NE inhibition by sivelestat mitigates ALI through amelioration of injuries in alveolar epithelium and vascular endothelium, as well as reversing the neutrophil-mediated increased vascular permeability. What is new and conclusions: Sivelestat, a selective NE inhibitor, has not been evaluated for its possible therapeutic effects against SARS-CoV-2 infection. Based on its promising beneficial effects in underlying complications of COVID-19, sivelestat could be considered as a promising modality for better management of COVID-19–induced ALI/ARDS or coagulopathy. © 2020 John Wiley & Sons Ltd
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