Neutrophil Elastase Inhibitors: A potential prophylactic treatment option for SARS-CoV-2-induced respiratory complications?

“Repurposing” existing drugs to fight COVID-19 remains an important strategy. Since respiratory failure remains one of the leading causes of death in COVID-19 patients, in this commentary, we have critically discussed the potential benefit of neutrophil elastase inhibitors (NEIs) in patients hospitalised with severe COVID-19. Around one in three COVID-19 patients admitted to a hospital develop systemic inflammatory conditions such as cytokine release syndrome (CRS) [1] and acute respiratory distress syndrome (ARDS) [2]. Since lymphocytopenia is often reported in severe COVID-19 patients, it suggests that systemic inflammatory complications, associated with disease severity and mortality, are likely to be mediated by leukocytes other than T cells [3]. Aikawa N, Kawasaki Y. Clinical utility of the neutrophil elastase inhibitor sivelestat for the treatment of acute respiratory distress syndrome.