TY - JOUR T1 - Inhaled and systemic heparin as a repurposed direct antiviral drug for prevention and treatment of COVID-19 JF - Clinical Medicine JO - Clin Med SP - e218 LP - e221 DO - 10.7861/clinmed.2020-0351 VL - 20 IS - 6 AU - Carina Conzelmann AU - Janis A Müller AU - Lukas Perkhofer AU - Konstantin MJ Sparrer AU - Alexander N Zelikin AU - Jan Münch AU - Alexander Kleger Y1 - 2020/11/01 UR - http://www.rcpjournals.org/content/20/6/e218.abstract N2 - Here, we advocate a highly favourable opportunity for the treatment of COVID-19 disease by repurposing a long-serving medical agent with an excellent history of clinical use, namely heparin. Heparin is best known as an anticoagulant, but it also exhibits direct antiviral activity against many enveloped viruses and has anti-inflammatory activity. The high incidence of thromboembolic events in COVID-19 patients suggests that coagulopathy plays an important role in the SARS-CoV-2 pathogenesis. This already makes heparin a unique, potentially curative agent that can be used immediately to help resolve the ongoing crisis associated with SARS-CoV-2 infection and COVID-19 disease. We demonstrate here in vitro that heparin does indeed inhibit SARS-CoV-2 infection. The three concurrent modes of activity of heparin (antiviral, anticoagulant and anti-inflammatory) against SARS-CoV-2/COVID-19 form a unique therapeutic combination. Thus, repurposing of heparin to fight SARS-CoV-2 and COVID-19 appears to be a powerful, readily available measure to address the current pandemic. ER -