SARS-Cov-2 is the culprit behind the acute respiratory syndrome COVID-19. Immunopathological mechanisms that cause excessive inflammation and neutrophil activation cause this syndrome. Neutrophils are crucial for the removal of viruses and other infectious agents. This study aims to comprehensively examine the relationship between elastase enzymes and COVID-19, as well as natural resources as elastase inhibitors. The literature was searched using electronic databases such as Directory Open-Access Journal, Google Scholar, National Health Institute, PubMed, ScienceDirect, and Web of Science between October 2021 and August 2022. This narrative review article highlights some aspects of the relationship between elastase and COVID-19, including the general pathophysiology of COVID-19, protease enzymes and protease inhibitors, neutrophil extracellular traps (NET), NET cell death, elastin and desmosine, elastase and antielastase, elastase and thrombin, elastase and angiotensin-converting enzyme 2 (ACE2), elastase and cathepsin C, correlation of elastase and COVID-19, COVID-19 therapy, and natural products resource as elastase inhibitors.
Key words: COVID-19, elastase inhibition, natural products, neutrophil elastase