Study finds that Hyaluronan is causing long-term lung damage in COVID-19 infected individuals

Medical News: A recent study published by a team of Swedish researchers has uncovered significant findings on the effects of COVID-19 on the lungs. The study specifically focuses on a molecule called hyaluronan (HA), which plays a major role in how the lungs are impacted by the SARS-CoV-2 virus. This Medical News will delve into the key discoveries and their implications for people suffering from COVID-19 and long-term lung damage.


Study finds that Hyaluronan is causing long-term lung damage in COVID-19
infected individuals

Researchers previously noted that the lungs of patients who died from COVID-19 were filled with a clear, jelly-like substance, identified as hyaluronan. Hyaluronan, commonly known as HA, is a naturally occurring molecule in the body that helps with tissue repair and cellular processes. However, in the case of COVID-19, this molecule was found to contribute to severe respiratory problems and long-term damage.
 
What the Study Revealed
This study is unique in its focus on HA levels at various stages of COVID-19 infection, particularly in people who experienced severe disease. By using advanced imaging techniques like 3D light sheet fluorescent microscopy, the researchers discovered a critical difference in the lungs of COVID-19 patients compared to healthy individuals.
 
Key Findings
The lungs of those who had severe COVID-19 were filled with fragmented HA, which was found to be linked to inflammation. This accumulation of HA disrupts the gas exchange process in the lungs, which is vital for breathing.
 
Moreover, HA levels remained high even during the recovery phase, meaning the molecule’s presence in the body could contribute to ongoing respiratory problems long after the acute infection has subsided.
 
The Role of Hyaluronan in Lung Damage
The study showed that HA is an important factor in lung damage during and after COVID-19. In healthy tissues, HA exists in a form that helps reduce inflammation. However, in COVID-19 patients, it becomes fragmented into smaller pieces, which actually increase inflammation. This inflammation can cause severe lung damage and make it difficult for patients to recover normal lung function.

The researchers noted that the smaller fragments of HA not only contribute to inflammation but also trigger the movement of immune cells to the lungs, further exacerbating the damage. This finding is critical because it highlights how the body’s attempt to heal itself by producing more HA can ironically lead to greater harm, especially in severe COVID-19 cases.
 
Long-term Lung Function
The study also explored the long-term effects of high HA levels on lung function. In a group of 103 COVID-19 patients, the researchers found that individuals with severe cases had elevated levels of HA, both during the acute phase of the disease and months after recovery. These high HA levels were associated with reduced lung function, specifically a lower diffusion capacity (DLCO), which measures how well oxygen is transferred from the lungs into the blood.
 
Interestingly, this impairment was observed even in patients who had only mild symptoms during the initial phase of COVID-19. This suggests that even people who did not require hospitalization may still face long-term consequences due to elevated HA levels in their lungs.
 
The study’s findings were reinforced by the use of a 3D-lung model, which simulated the effects of the virus on human lung cells. This model confirmed that SARS-CoV-2 directly influences HA metabolism, causing an overproduction of HA in the lungs.
 
Could Corticosteroids Be the Answer?
One of the most important discoveries of this study is the potential for corticosteroids, such as dexamethasone, to help manage HA levels in COVID-19 patients. Dexamethasone is already known to reduce inflammation in COVID-19 patients and improve outcomes for those who are severely ill. But now, researchers believe it also plays a crucial role in regulating HA production.
 
The study demonstrated that corticosteroids can reduce the activity of enzymes responsible for producing HA, thereby lowering the overall levels of the molecule in the lungs. In the in vitro 3D-lung model, treatment with corticosteroids not only reduced inflammation but also prevented the overproduction of HA caused by the SARS-CoV-2 virus.
 
These findings suggest that corticosteroid treatment may be a promising approach for preventing long-term lung damage in COVID-19 patients by keeping HA levels in check.
 
Hyaluronan as a Biomarker
Beyond its role in causing lung damage, HA could also serve as a useful biomarker for predicting the severity of COVID-19 in patients. The study found a clear correlation between high HA levels and more severe disease outcomes. This means that measuring HA levels in COVID-19 patients might help doctors determine which patients are at risk of developing long-term complications.

In addition to being a biomarker for disease severity, HA could also guide personalized treatment strategies. By identifying patients with particularly high HA levels, healthcare providers may be able to tailor treatments to better manage the risk of lung damage.
 
Future Therapeutic Approaches
The study’s findings have opened up new avenues for research and treatment. While corticosteroids have shown promise in controlling HA levels, researchers are also exploring other drugs that specifically target HA production. One such drug, hymecromone, is already approved for treating other conditions and has been shown to reduce HA levels in clinical trials. The use of such targeted treatments could provide a more precise way of managing HA-related complications in COVID-19 patients.
 
Furthermore, the study found that HA levels remain elevated even in the long-term recovery phase, suggesting that treatments aimed at reducing HA production might need to be extended beyond the acute phase of the disease to prevent long-term lung damage.
 
Conclusions
The study findings have provided valuable insights into the role of hyaluronan in COVID-19. It is clear that HA plays a significant role in both the acute and long-term effects of the disease, contributing to inflammation, lung damage, and reduced lung function. However, the discovery that corticosteroids and other drugs can help regulate HA levels offers hope for better treatments in the future.
 
As researchers continue to explore the role of HA in COVID-19, there is a growing possibility that new therapeutic approaches could be developed to prevent long-term complications in patients. For now, it seems that managing HA levels could be key to improving outcomes for those suffering from severe COVID-19.
 
The study findings were published in the peer reviewed journal: mBio.
https://journals.asm.org/doi/10.1128/mbio.01303-24
 
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