Neutrophil Elastase Inhibitor (Sivelestat), may be a Promising
Therapeutic Option for Management of Acute Lung Injury/Acute Respiratory
Distress Syndrome or Disseminated Intravascular Coagulation in COVID-19
Abstract
This article summarizes the effects of sivelestat on ALI/ARDS or ARDS
with coagulopathy, both of which are frequently seen in patients with
COVID-19. The emergence of the novel 2019-nCoV infection has been a
global pandemic. The following databases were searched to identify
relevant literature concerning empirical evidence: The Cochrane library,
Pubmed, Medline, EMBASE from 1980 through March 2020. COVID-19 patients
are more susceptible to thromboembolic diseases including DIC. In this
connection, various studies have emphasized on the role of neutrophil
elastase (NE) in the development of DIC in patients with ARDS and
sepsis. It has been shown that NE inhibition by sivelestat mitigates ALI
through amelioration of alveolar epithelium and vascular endothelium
injuries as well as reversing the activated neutrophil-mediated
increased vascular permeability. Sivelestat is a selective NE inhibitor
has not been evaluated for its possible therapeutic effects against
SARS-CoV-2 infection and/or COVID-19. Nevertheless, based on its
promising beneficial effects in underlying complications of COVID-19,
sivelestat could be considered as a promising treatment for the
management of ALI/ARDS or coagulopathy in patients with COVID-19.