Elevated Plasmin(ogen) as a Common Risk Factor for COVID-19 Susceptibility.
Hong-Long Ji1, Runzhen Zhao1, Sadis Matalon1
1Department of Cellular and Molecular Biology, University of Texas Health Science Centre at Tyler, Tyler, Texas; Texas Lung Injury Institute, University of Texas Health Science Centre at Tyler, Tyler, Texas; Department of Anesthesiology and Perioperative Medicine, Division of Molecular and Translational Biomedicine, Pulmonary Injury and Repair Center, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; and Department of Medicine and Anesthesia, University of California San Francisco, San Francisco, California.
Patients with common conditions like hypertension and diabetes face worse COVID-19 outcomes due to elevated plasmin(ogen). This protein may increase SARS-CoV-2 infectivity and virulence, suggesting it as a therapeutic target.
Area of Science:
- Biochemistry
- Virology
- Pathophysiology
Background:
- Patients with hypertension, diabetes, and other chronic conditions experience severe COVID-19 outcomes.
- The underlying mechanisms linking these comorbidities to SARS-CoV-2 severity remain unclear.
Purpose of the Study:
- To review evidence on elevated plasmin(ogen) levels in COVID-19 patients with comorbid conditions.
- To explore the role of plasmin(ogen) in SARS-CoV-2 infection and virulence.
Main Methods:
- Literature review of studies investigating plasmin(ogen) and COVID-19.
- Analysis of the proposed mechanism involving plasmin cleavage of the SARS-CoV-2 spike protein furin site.
Main Results:
- Evidence suggests elevated plasmin(ogen) in COVID-19 patients with comorbidities.
- Plasmin may enhance SARS-CoV-2 infectivity by cleaving the S protein's furin site.
- Hyperfibrinolysis, linked to plasmin, correlates with elevated D-dimer in severe cases.
Conclusions:
- The plasmin(ogen) system is implicated in the pathogenesis of severe COVID-19 in patients with comorbidities.
- Targeting the plasmin(ogen) system presents a potential therapeutic strategy against COVID-19.
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