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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
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  • Adeleh Sahebnasagh,
  • Fatemeh Saghafi ,
  • Mohammadreza Safdari ,
  • Masoud Khataminia,
  • Afsaneh Sadremomtaz,
  • Hassan Rezai Ghaleno,
  • Mahdi Bagheri ,
  • Mohammad Sadegh Bagheri ,
  • Solomon Habtemariam,
  • Razieh Avan
Adeleh Sahebnasagh
North Khorasan University of Medical Sciences

Corresponding Author:[email protected]

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Fatemeh Saghafi
Shahid Sadoughi University of Medical Sciences and Health Services
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Mohammadreza Safdari
North Khorasan University of Medical Sciences
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Masoud Khataminia
Tehran University of Medical Sciences
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Afsaneh Sadremomtaz
University of Groningen
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Hassan Rezai Ghaleno
Lorestan University of Medical Sciences
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Mahdi Bagheri
Baqiyatallah University of Medical Sciences
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Mohammad Sadegh Bagheri
Baqiyatallah University of Medical Sciences
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Solomon Habtemariam
University of Greenwich
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Razieh Avan
Birjand University of Medical Sciences
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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.