Another new application of heparin in COVID-19: more than
anticoagulation and antiviral
Xianqiang Yu1 PhD
1 Southeast
University, Medical School, Nanjing, China
#Correspondence: Xianqiang Yu, PhD, E-mail:
yuxianqiang302@126.com, Medical School of Nanjing University, Nanjing,
China, Telephone: +86 18553263899.
Abstract: Heparin is used as a classic anticoagulant in clinic.
In addition, with the ongoing pandemic and unknown challenges, the
mechanism of action of heparin in antiviral and anti-inflammatory
aspects has been constantly discovered and clarified. This also provides
effective support for the treatment of COVID-19 in specific contexts.
Most importantly, heparin may act as a multi-drug.
Keywords: COVID-19; heparin; anticoagulant, anti-inflammatory,
antiviral
Dear editor, we read with great interest an article in your journal
about heparin inhibits the infection of novel coronavirus [1].
Therefore, we were surprised to learn that heparin is a classic
anticoagulant that has antiviral effects. Especially in the context of
the pandemic, it provides hope for clinician decision making for the
treatment of COVID-19 patients. In particular, there is still no
accurate and effective anti-novel coronavirus intervention drugs in
clinical practice. However, we would like to emphasize that heparin may
have a key anti-inflammatory effect on severe COVID-19.
Heparin has been widely used clinically for its classical anticoagulant
effects, including sepsis induced coagulopathy. It is reported that
heparin has been shown to have a significant effect on blocking the
inflammatory storm of sepsis in an unprecedented way. In general,
heparin inhibits HMGB1 - lipopolysaccharide (LPS) interactions and
prevents macrophage heparinase from degrading glycocalyx [2]. To the
best of our knowledge, HMGB1 is an important part of the
damage-associated molecular patterns (DAMPs) family. In addition, the
study suggests that even if the anticoagulant part of heparin was
removed, it could also play a significant anti-inflammatory effect in
sepsis through the HMGB1 pathway. In other words, modified heparin can
be used in other inflammatory diseases without concern for its classical
pharmacological side effects.
As COVID-19 continues and it presents new challenges, efficient
antiviral and anti-inflammatory drugs are urgently needed clinically.
Most important of all, antiviral, anti-inflammatory, and anti-coagulant
therapies are three important aspects of COVID-19 therapy. Intriguingly,
heparin has exactly three potential therapeutic effects, and it is
therefore possible to kill many birds with one arrow. There may be a
basis for using heparin aggressively in these patients in the future.
Despite the fact that it is an old drug, we still have reason to be
optimistic.