Enoxaparin improves COVID-19 by reducing Neutrophils Extracellular Traps (NETs) production

Clin Immunol. 2023 Dec:257:109836. doi: 10.1016/j.clim.2023.109836. Epub 2023 Nov 10.

Abstract

Background: COVID-19 causes consequences such as imbalance of the immune system and thrombotic events. During the infection process, NETs in excess induce a pro-inflammatory response and disseminated intravascular coagulation. We evaluated the role of enoxaparin as a potential inhibitor of NETs.

Methods: K18-hACE2 animals infected with the SARS-CoV-2 virus and a group of 23 individuals admitted to the hospital with COVID-19 treated with enoxaparin or without treatment and controls without the disease were included.

Results: Enoxaparin decreased the levels of NETs, reduced the signs of the disease and mitigated lung damage in the animals infected with SARS-CoV-2. These effects were partially associated with prevention of SARS-CoV-2 entry and NETs synthesis. Clinical data revealed that treatment with enoxaparin decreased the levels of inflammatory markers, the levels of NETs in isolated neutrophils and the organ dysfunction.

Conclusion: This study provides evidence for the beneficial effects of enoxaparin in COVID-19 in addition to its anticoagulant role.

Keywords: Enoxaparin; Inflammatory markers; Lung injury; NETs; SARS-CoV-2.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • COVID-19*
  • Enoxaparin / pharmacology
  • Extracellular Traps*
  • Humans
  • Neutrophils
  • SARS-CoV-2

Substances

  • Enoxaparin