Elevated Plasmin(ogen) as a Common Risk Factor for COVID-19 Susceptibility
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Open Access
- 1 July 2020
- journal article
- review article
- Published by American Physiological Society in Physiological Reviews
- Vol. 100 (3), 1065-1075
- https://doi.org/10.1152/physrev.00013.2020
Abstract
Patients with hypertension, diabetes, coronary heart disease, cerebrovascular illness, chronic obstructive pulmonary disease, and kidney dysfunction have worse clinical outcomes when infected with SARS-CoV-2, for unknown reasons. The purpose of this review is to summarize the evidence for the existence of elevated plasmin(ogen) in COVID-19 patients with these comorbid conditions. Plasmin, and other proteases, may cleave a newly inserted furin site in the S protein of SARS-CoV-2, extracellularly, which increases its infectivity and virulence. Hyperfibrinolysis associated with plasmin leads to elevated D-dimer in severe patients. The plasmin(ogen) system may prove a promising therapeutic target for combating COVID-19.Keywords
Funding Information
- NHLBI (HL87017, HL095435, HL134828)
- NIEHS (5U01ES026458, 5U01ES027697)
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