PMC:7386875 / 53722-55618
Annnotations
{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7386875","sourcedb":"PMC","sourceid":"7386875","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7386875","text":"A recent meta-analysis has demonstrated that antiplatelet therapy is associated with improved mortality from sepsis.160 Interestingly, the majority of data linking antiplatelet therapy with these improved clinical outcomes relates to aspirin.161 In this regard, recent experimental data have highlighted that targeting platelets with aspirin prevents intravascular coagulation and neutrophil-mediated microvascular thrombosis in a mouse model of bacterial sepsis.162 However, to date, the effect of aspirin in COVID-19 remains to be established. Several other therapies with antiplatelet effects, including dipyridamole and nafamostat, are currently being evaluated for their potential role in reducing the severity of COVID-19. The antiplatelet agent dipyridamole has recently been reported to suppress SARS-CoV-2 replication in vitro, with some early data suggesting that use of adjunct dipyridamole may improve the clinical course in severe COVID-19.163 Finally, the role of nafamostat, a serine protease inhibitor which has antiplatelet effects and is currently marketed in Asia for the treatment of disseminated intravascular coagulation and pancreatitis, is being evaluated.164 Nafamostat is known to inhibit TMPRSS-2, and in preclinical studies, serine protease inhibitors are able to block SARS-CoV-2 infection of lung cells. Prior studies of nafamostat demonstrated that the drug has potential in blocking MERS-CoV infection in vitro, suggesting a potential role for this drug in reducing the burden of severe COVID-19.5,165 The RACONA Study (URL: https://www.clinicaltrials.gov. Unique identifier: NCT04352400) is a double-blind trial set to evaluate the efficacy of this agent in severe COVID-19. Nonetheless, it remains to be seen if any of these investigational therapies by virtue of their antiplatelet or antiviral effects will play a substantial role in the treatment of 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