Assessment of the role of neutrophil extracellular traps in SARS-CoV-2 pneumonia

Abstract

BACKGROUND: Abnormal neutrophil extracellular traps are associated with lung diseases, thrombosis, increased mucosal secretion in the airways. The aim of this study is to evaluate the possible place of the most specifi c NETosis marker Cit-H3 protein in diagnostic algorithms by revealing its relationship with the severity, mortality and prognosis of SARS-CoV-2 pneumonia. PATIENTS AND METHODS: Patients (n=78) who applied to the Emergency Department between March 11, 2020 and June 10, 2020, with positive SARS-CoV-2 polymerase chain reaction (PCR) test and lung involvement were included in the prospective study. Serum Cit-H3 levels and critical laboratory parameters were measured at baseline on the day of clinical deterioration and before recovery/discharge/death. Cit-C3 levels were determined by enzyme immunassay method. RESULTS: Cit-H3 levels in patients with SARS-CoV-2 pneumonia during their fi rst admission to the hospital were signifi cantly higher compared to the healthy control group (p<0.05). Repeated measurements of Cit-H3 levels of the patients signifi cantly correlated with D-dimer, procalcitonin, Neutrophil/ Lymphocyte ratio, lymphocyte, CRP, and oxygen saturation. Cit-H3 levels of the patients who died were signifi cantly higher than that of those who survived (p<0.05). Cit-H3 levels were found to be statistically signifi cantly higher in patients who developed acute respiratory distress syndrome, were admitted to the intensive care unit, and had mortality (p<0.05). CONCLUSIONS: Cit-H3 plays a role in infl ammatory processes in SARS-CoV-2 pneumonia, and changes in serum Cit-H3 levels of these patients can be used to determine prognosis and mortality