The diverse role of heparan sulfate and other GAGs in SARS-CoV-2 infections and therapeutics

Friederike Eilts, Sarah Bauer, Keith Fraser, Jonathan S. Dordick, Michael W. Wolff, Robert J. Linhardt, Fuming Zhang

Research output: Contribution to journalReview articlepeer-review


In December 2019, the global coronavirus disease 2019 (COVID-19) pandemic began in Wuhan, China. COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which infects host cells primarily through the angiotensin-converting enzyme 2 (ACE2) receptor. In addition to ACE2, several studies have shown the importance of heparan sulfate (HS) on the host cell surface as a co-receptor for SARS-CoV-2-binding. This insight has driven research into antiviral therapies, aimed at inhibiting the HS co-receptor-binding, e.g., by glycosaminoglycans (GAGs), a family of sulfated polysaccharides that includes HS. Several GAGs, such as heparin (a highly sulfated analog of HS), are used to treat various health indications, including COVID-19. This review is focused on current research on the involvement of HS in SARS-CoV-2 infection, implications of viral mutations, as well as the use of GAGs and other sulfated polysaccharides as antiviral agents.

Original languageEnglish
Article number120167
JournalCarbohydrate Polymers
StatePublished - 1 Jan 2023
Externally publishedYes


  • Glycosaminoglycans
  • Heparan sulfate co-receptor
  • Receptor binding domain
  • SARS-CoV-2
  • Spike protein


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