Association of vascular netosis with COVID-19 severity in asymptomatic and symptomatic patients

Suman Kapoor; Lucia Mihalovičová; Ekaterina Pisareva; Brice Pastor; Alexia Mirandola; Benoit Roch; Joe Bryant; Anna Philip Princy; Salem Chouaib; Alain Roger Thierry

doi:10.1016/j.isci.2024.109573

Association of vascular netosis with COVID-19 severity in asymptomatic and symptomatic patients

iScience. 2024 Mar 26;27(5):109573. doi: 10.1016/j.isci.2024.109573. eCollection 2024 May 17.

Authors

Suman Kapoor¹, Lucia Mihalovičová^{2

3}, Ekaterina Pisareva², Brice Pastor², Alexia Mirandola², Benoit Roch², Joe Bryant⁴, Anna Philip Princy⁵, Salem Chouaib^{1

6}, Alain Roger Thierry^{2

7}

Affiliations

¹ Thumbay Research Institute for Precision Medicine, Gulf Medical University, Ajman, UAE.
² IRCM, Institute of Research in Cancerology of Montpellier, INSERM U1194, Centre Hospitalier Universitaire, University of Montpellier, Montpellier, France.
³ Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Sasinkova, Bratislava, Slovakia.
⁴ Institute of Human Virology, Baltimore, MD, USA.
⁵ Thumbay University Hospital, Ajman, UAE.
⁶ Institut Gustave Roussy, Villejuif, France.
⁷ Montpellier Cancer Institute (ICM), Montpellier, France.

Abstract

We examined from a large exploratory study cohort of COVID-19 patients (N = 549) a validated panel of neutrophil extracellular traps (NETs) markers in different categories of disease severity. Neutrophil elastase (NE), myeloperoxidase (MPO), and circulating nuclear DNA (cir-nDNA) levels in plasma were seen to gradually and significantly (p < 0.0001) increase with the disease severity: mild (3.7, 48.9, and 15.8 ng/mL, respectively); moderate (9.8, 77.5, and 27.7 ng/mL, respectively); severe (11.7, 99.5, and 29.0 ng/mL, respectively); and critical (13.1, 110.2, and 46.0 ng/mL, respectively); and are also statistically different with healthy individuals (N = 140; p < 0.0001). All observations made in relation to the Delta variant-infected patients are in line with Omicron-infected patients. We unexpectedly observed significantly higher levels of NETs in asymptomatic individuals as compared to healthy subjects (p < 0.0001). Moreover, the balance of cir-nDNA and circulating mitochondrial DNA level was affected in COVID-19 infected patients attesting to mitochondrial dysfunction.

Keywords: Health sciences; Immunology; Medical microbiology; Public health.