Neutrophil extracellular traps (NETs) and COVID-19: a literature review

Abstract

Since its outbreak, the COVID-19 pandemic cost millions of human lives and had an unprecedented negative impact on health systems worldwide. Although the administration of vaccines slowed the disease's spread, there is still date no specific treatment for critically ill patients. Part of this is due to our poor understanding of the pathophysiology of the disease. As is well known, SARS-CoV-2 infection caused multisystemic damage with a phenomenon known as immunothrombosis, which has been linked to an "old enemy," the neutrophil extracellular traps (NETs), which could be the source of endothelial damage and part of the prothrombotic state of the disease. Several studies documented the relationship between NET formation and the severity of the disease and even the mortality caused by it. Based on this premise, it has been suggested that NET can be a therapeutic target; however, there have been very few studies on the topic, rendering us unable to draw firm conclusions. We believe that understanding the complex mechanism between NETs and COVID may lead to a more robust theory, which in turn facilitates the development of drugs that are able to curb the high mortality rate caused by this disease