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QJM - Monthly Journal of the Association of Physicians 2020-Apr

Plasminogen improves lung lesions and hypoxemia in patients with COVID-19.

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Yuanyuan Wu
Ting Wang
Chunying Guo
Dongmei Zhang
Xiaojing Ge
Zhaoxing Huang
Xianshan Zhou
Yinping Li
Qingzhen Peng
Jinan Li

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Abstracto

Lungs from patients with coronavirus disease 2019 (COVID-19) have shown typical signs of acute respiratory distress syndrome (ARDS), formation of hyaline membrane mainly composed of fibrin, and 'ground-glass' opacity. Previously, we showed plasminogen itself is a key regulator in fibrin degradation, wound healing and infection.We aimed to investigate whether plasminogen can improve lung lesions and hypoxemia of COVID-19.Thirteen clinically moderate, severe or critical COVID-19 patients were treated with atomization inhalation of freeze-dried plasminogen.Levels of their lung lesions, oxygen saturation and heart rates were compared before and after treatment by CT scanning images and patient monitor.After plasminogen inhalation, conditions of lung lesions in 5 clinically moderate patients have quickly improved, shown as the decreased range and density of 'ground glass' opacity. Improvements of oxygen saturation were observed in 6 clinically severe patients. In the 2 patients with critical conditions, the oxygen levels have significantly increased from 79-82% to 91% just about 1 hour after the first inhalation. In 8 of 13 patients the heart rates had slowed down. For the 5 clinically moderate patients, the difference is even statistically significant. Furthermore, a general relief of chest tightness was observed.Whereas it is reported that plasminogen is dramatically increased in adults with ARDS, this study suggests that additional plasminogen may be effective and efficient in treating lung lesions and hypoxemia during COVID-19 infections. Although further studies are needed, this study highlights a possible hope of efficiently combating this rapid epidemic emergency.

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