Abstract
NETosis is a form of neutrophil death leading to the release of extracellular chromatin and the assembling of proteins, including antiviral proteins, primed by an initial pathogenic stimulus. Under certain specific conditions, neutrophils can exhibit a double-edged activity. This event has been implicated in COVID-19 among other conditions. Neutrophil extracellular traps (NETs) are involved in the pathogenesis of COVID-19 by promoting a pro-inflammatory and a procoagulant state leading to multiorgan failure. This particular form of host defense promoted by neutrophils is closely related to the well-known cytokine storm observed in severe COVID-19 patients. These two elements therefore represent possible targets for treatment of severe SARS-CoV-2 infections.
Highlights
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is responsible for the ongoing pandemic and is associated with significant morbidity and mortality
In the presence of a neutralizing anti-hACE2 antibody or a transmembrane protease serine 2 (TMPRSS2) inhibitor, like bromhexine which has not demonstrated any difference in terms of efficacy with placebo according to a clinical trial (Veras et al, 2020), the ability of the virus to induce the release of Neutrophil extracellular traps (NETs) was abrogated
This review has highlighted the importance of NETs in a pathology such as COVID-19 their impact was already known in some autoimmune diseases such as systemic lupus erythematosus
Summary
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is responsible for the ongoing pandemic and is associated with significant morbidity and mortality. The HKU1, the NL63, the OC43 and the 229E are four common endemic coronaviruses causing diseases of low intensity These four coronaviruses are called non-severe acute respiratory syndrome (SARS)-like coronaviruses (Coronaviridae Study Group of the International Committee on Taxonomy of Viruses, 2020). The first, which has become pandemic, was the SARS-CoV-1 (initially called “SARS-CoV”) reported in November 2002, followed by the Middle East respiratory syndrome CoV (the MERS-CoV) a decade later in June 2012 These two pandemics are over (Coronaviridae Study Group of the International Committee on Taxonomy of Viruses, 2020). Other variants will certainly emerge following a Darwinian evolution till full, ideally worldwide, protection afforded with massive vaccination This virus is mainly transmitted via the respiratory tract and is airborne via microdroplets. Beside the hopes of vaccine efficacy for reducing the spread of COVID-19 and its severity, a thorough knowledge of the underlying physiopathological mechanisms of the disease is of upmost importance for the development of the most optimal treatments
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