Ontong Pawared, Prachayasittikul Virapong
Department of Community Medical Technology, Faculty of Medical Technology, Mahidol University, Nakhon Pathom 73170, Thailand.
Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok 10700, Thailand.
EXCLI J. 2021 Jan 15;20:117-125. doi: 10.17179/excli2020-3215. eCollection 2021.
Coronavirus disease 2019 (COVID-19) is a pandemic viral pneumonia caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2). Most of the severe COVID-19 patients come up with trouble breathing, persistent pressure in the chest and developing to acute respiratory distress syndrome (ARDS) with a high mortality rate. Infected lung brings about uncontrolled inflammation followed by the fluid leakage and accumulation of extracellular matrix. Hyaluronan (HA) is an essential component of the extracellular matrix (ECM) and plays crucial roles in both biological and pathological states. It is also primarily located within the respiratory airways and is uprising during COVID-19 infection. Hitherto, the association between COVID-19 pathophysiology and HA is still unclear. Herein, we provide an overview of the pathophysiology of SARS-CoV-2 infection in conjunction with the involvement of HA and the diminution of HA for therapeutic potential of COVID-19. For severe patients, HA depletion may be beneficial for preventing ARDS while monitoring and managing HA level in lung may improve survival rate of patients.
2019冠状病毒病（COVID-19）是一种由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的大流行性病毒性肺炎。大多数重症COVID-19患者会出现呼吸困难、持续胸痛，并发展为急性呼吸窘迫综合征（ARDS），死亡率很高。受感染的肺部会引发不受控制的炎症，随后出现液体渗漏和细胞外基质积聚。透明质酸（HA）是细胞外基质（ECM）的重要组成部分，在生理和病理状态中都起着关键作用。它也主要位于呼吸道，在COVID-19感染期间会升高。迄今为止，COVID-19病理生理学与HA之间的关联仍不清楚。在此，我们结合HA的参与情况以及HA的减少对COVID-19治疗潜力的影响，对SARS-CoV-2感染的病理生理学进行概述。对于重症患者，减少HA可能有利于预防ARDS，而监测和管理肺部的HA水平可能提高患者的生存率。
