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The reason behind severe COVID-19 in patients with comorbidities

By Jahanbee Gupta

Patients with hypertension, diabetes, a coronary heart condition, cerebrovascular illness, chronic obstructive pulmonary disease, and kidney dysfunction have worse clinical outcomes when infected with SARS-CoV-2, for unspecified reasons. the aim of this review is to summarize the evidence for the existence of elevated plasmin in COVID-19 patients with these comorbid conditions. Plasmin, and other proteases, may cleave a newly inserted furin site within the S protein of SARS-CoV-2, extracellularly, which increases its infectivity and virulence. Hyperfibrinolysis related to plasmin results in elevated D-dimer in severe patients. The plasmin system may prove a favourable therapeutic target for combating COVID-19. The high levels of plasmin (a protease) within the body could also be the rationale why those with comorbidities get severe COVID-19, claimed by a gaggle of researchers at the University of Alabama at Birmingham.

Plasmin is an enzyme that breaks down fibrin (a protein that forms mesh during a blood clot) and dissolves blood clots within the body. Those with severe COVID-19 show high levels of fibrin degradation products and platelets (blood cells that are involved in clotting) points to increased fibrinolysis (the breakdown of fibrin). To do clinical trials to affirm their findings, the research team is already enrolling volunteers.

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