Abstract
Lower respiratory tract (LRT) disease induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can deteriorate to acute respiratory distress syndrome (ARDS). Because the release of neutrophil extracellular traps (NETs) is implicated in ARDS pathogenesis, we investigated the presence of NETs and correlates of pathogenesis in blood and LRT samples of critically ill patients with COVID-19. Plasma NET levels peaked early after intensive care unit admission and were correlated with the SARS-CoV-2 RNA load in sputum and levels of neutrophil-recruiting chemokines and inflammatory markers in plasma samples. The baseline plasma NET quantity was correlated with disease severity but was not associated with soluble markers of thrombosis or with development of thrombosis. High NET levels were present in LRT samples and persisted during the course of COVID-19, consistent with the detection of NETs in bronchi and alveolar spaces in lung tissue from deceased patient with COVID-19. Thus, NETs are produced and retained in the LRT of critically ill patients with COVID-19 and could contribute to SARS-CoV-2-induced ARDS disease.
Keywords: COVID-19; SARS-CoV-2; acute respiratory distress syndrome; neutrophil extracellular traps; neutrophils.
【저자키워드】 COVID-19, Neutrophils, SARS-CoV-2, acute respiratory distress syndrome, Neutrophil extracellular traps, 【초록키워드】 severe acute respiratory syndrome coronavirus 2, Neutrophils, Respiratory distress syndrome, ARDS, coronavirus, Pathogenesis, thrombosis, intensive care, acute respiratory distress syndrome, Neutrophil extracellular traps, disease severity, neutrophil, inflammatory markers, chemokines, severe acute respiratory syndrome Coronavirus, sputum, chemokine, RNA, Critically ill, Neutrophil extracellular trap, plasma, Inflammatory marker, respiratory tract, respiratory, disease, Admission, NETs, critically ill patients, Blood, acute respiratory distress, marker, intensive care unit admission, Deceased, Lower respiratory tract, respiratory distress, alveolar spaces, Critically ill patient, acute respiratory syndrome, acute respiratory syndrome coronavirus, plasma samples, syndrome, lung tissue, Lower, alveolar, NET, patient with COVID-19, Extracellular, Course, produced, investigated, peaked, contribute, correlated, retained, implicated, baseline, deteriorate, LRT, the SARS-CoV-2, with COVID-19, 【제목키워드】 Lower, tract, Level, Ill,