key: cord-0738045-sa79dgsp
authors: Yu, Xianqiang
title: Potential of Heparin in the Treatment of COVID-19–Associated Myocarditis
date: 2022-01-12
journal: Pediatr Emerg Care
DOI: 10.1097/pec.0000000000002645
sha: 97eb99400d719bb6715f59f31e65e9e9adc44822
doc_id: 738045
cord_uid: sa79dgsp

nan

W e read with great interest an article in your journal about the evaluation of COVID-19-associated myocarditis. 1 As far as we know, COVID-19 is an infectious disease characterized by respiratory symptoms that can affect multiple organs throughout the body. 2 Because of its own characteristics, myocardial cells are easily attacked and infected by viruses. It is clear that myocardial injury poses not only a huge challenge to the management of COVID-19 but also a greater burden for patients. Therefore, it is also important to distinguish COVID-19 myocarditis from other types of myocarditis as early as possible for the diagnosis and treatment of the disease.

Heparin has been widely used in clinic for its traditional anticoagulant effect. However, recent studies have elucidated the antiinflammatory mechanism of heparin. 3 Heparin mainly inhibits HMGB1-lipopolysaccharide interactions and prevents macrophage heparinase from degrading glycocalyx. To the best of our knowledge, HMGB1 is a well-studied component of the damage-associated molecular pattern family. This gives us a lot of insight into the potential use of heparin as an antiinflammatory treatment for COVID-19associated myocarditis. In addition, the anticoagulant effect of heparin itself, combined with its potential anti-inflammatory effect, may have multiple clinical effects on the anticoagulant effect of heart microcirculation caused by viral myocarditis injury and the improvement of hypercoagulant state of heart cavity.

As the pandemic continues and the cardiovascular system presents a significant risk, we urgently need more clinical evidence of the multiple values of heparin in COVID-19 myocarditis. Heparin has the potential to alter the clinical course and prognosis of patients with COVID-19-associated myocarditis as an ongoing trial of an old drug.

ACKNOWLEDGMENT Funding: Scholarship of Southeast University (no. 189351).

Nanjing, China yuxianqiang302@126.com

Evaluation of COVID-19-associated myocarditis via pointof-care ultrasound in a pediatric patient

Organ-protective effect of angiotensin-converting enzyme 2 and its effect on the prognosis of COVID-19

Heparin prevents caspase-11-dependent septic lethality independent of anticoagulant properties

Author contributions: X.Y. completed the design and writing of the article and all the relevant content of the article.Disclosure: The author declares no conflict of interest.