Elevated Plasmin(ogen) as a Common Risk Factor for COVID-19 Susceptibility.
Physiol Rev. 2020 07 01;100(3):1065-1075
Authors: Ji HL, Zhao R, Matalon S, Matthay MA
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.
PMID: 32216698 [PubMed - indexed for MEDLINE]