Neutrophil Elastase Inhibitors: A potential prophylactic treatment option for SARS-CoV-2-induced respiratory complications?

• Published in: Critical care (London, England) Vol. 24; no. 1; pp. 311 - 2
• Main Authors: Mohamed, Mahmoud M A, El-Shimy, Ismail Amr, Hadi, Muhammad Abdul
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 08-06-2020; BioMed Central; BMC
• Subjects: Care and treatment; Clinical trials; Clinical Trials as Topic; Complications and side effects; Coronavirus Infections - complications; Coronavirus Infections - drug therapy; Coronavirus Infections - epidemiology; Coronaviruses; COVID-19; Critical care; Cytokines; Disease transmission; Hospitalization; Humans; Lymphocytes; Lymphoma; Mortality; Neutrophils; Pandemics; Patients; Pneumonia, Viral - complications; Pneumonia, Viral - drug therapy; Pneumonia, Viral - epidemiology; Preventive medicine; Proteinase Inhibitory Proteins, Secretory - therapeutic use; Proteins; Respiratory distress syndrome; Respiratory Distress Syndrome - drug therapy; Respiratory Distress Syndrome - virology; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Treatment Outcome; United Kingdom; United Kingdom; China
• ISSN: 1364-8535; 1466-609X; 1364-8535; 1366-609X
• DOI: 10.1186/s13054-020-03023-0

“Repurposing” existing drugs to fight COVID-19 remains an important strategy. Since respiratory failure remains one of the leading causes of death in COVID-19 patients, in this commentary, we have critically discussed the potential benefit of neutrophil elastase inhibitors (NEIs) in patients hospitalised with severe COVID-19. Around one in three COVID-19 patients admitted to a hospital develop systemic inflammatory conditions such as cytokine release syndrome (CRS) [1] and acute respiratory distress syndrome (ARDS) [2]. Since lymphocytopenia is often reported in severe COVID-19 patients, it suggests that systemic inflammatory complications, associated with disease severity and mortality, are likely to be mediated by leukocytes other than T cells [3]. Aikawa N, Kawasaki Y. Clinical utility of the neutrophil elastase inhibitor sivelestat for the treatment of acute respiratory distress syndrome.