Unraveled roles of hyaluronan in severe COVID-19


  • Pawared Ontong Department of Community Medical Technology, Faculty of Medical Technology, Mahidol University, Nakhon Pathom 73170, Thailand, Tel.: 662-441-4376, Fax: 662-441-4380; E-mail: pawared.ont@mahidol.ac.th https://orcid.org/0000-0002-4582-667X
  • Virapong Prachayasittikul Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Bangkok 10700, Thailand https://orcid.org/0000-0001-7942-1083




COVID-19, SARS-CoV-2, acute respiratory distress syndrome, hyaluronan, cytokine storm, 4-methylumbelliferone, hyaluronidase


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.



How to Cite

Ontong, P., & Prachayasittikul, V. (2021). Unraveled roles of hyaluronan in severe COVID-19. EXCLI Journal, 20, 117–125. https://doi.org/10.17179/excli2020-3215



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