Patients with hypertension, diabetes, coronary heart disease, cerebrovascular illness, chronic obstructive pulmonary disease, and kidney dysfunction have worse clinical outcomes when infected with SARS-CoV-2, for unknown reasons. The purpose of this review is to summarize the evidence for the existence of elevated plasmin(ogen) in COVID-19 patients with these comorbid conditions. Plasmin, and other proteases, may cleave a newly inserted furin site in the S protein of SARS-CoV-2, extracellularly, which increases its infectivity and virulence. Hyperfibrinolysis associated with plasmin leads to elevated D-dimer in severe patients. The plasmin(ogen) system may prove a promising therapeutic target for combating COVID-19.

中文翻译：

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纤溶酶（原）升高是 COVID-19 易感性的常见风险因素。

高血压、糖尿病、冠心病、脑血管疾病、慢性阻塞性肺疾病和肾功能不全的患者在感染 SARS-CoV-2 时临床结果更差，原因不明。本综述的目的是总结具有这些合并症的 COVID-19 患者存在纤溶酶（原）升高的证据。纤溶酶和其他蛋白酶可能会在细胞外切割 SARS-CoV-2 S 蛋白中新插入的弗林蛋白酶位点，从而增加其传染性和毒力。与纤溶酶相关的纤溶亢进导致重症患者 D-二聚体升高。纤溶酶（原）系统可能被证明是对抗 COVID-19 的有希望的治疗靶点。