Neutrophil extracellular traps, demographic, clinical, and laboratory parameters in COVID-19 patients: Impact on the severity and outcome during Omicron waves in Indonesia

Abstract

IntroductionIndonesia is significantly affected by the emergence of the Omicron variant during the coronavirus disease 2019 COVID-19 pandemic, with one of the most prominent case increases on February 2022 (third wave of the pandemic). Several factors, ranging from demographics to laboratory tests, have been linked to COVID-19 patients clinical manifestations and outcomes. One of the possible factors that can affect COVID-19 patients' status is the neutrophil extracellular traps (NETs). We aimed to determine NETs level along with demographic, clinical, and laboratory characteristics in COVID-19 patients and analyze its relationship with disease severity and survival. MethodsOne hundred confirmed COVID-19 patients at our hospital were recruited during February to September 2022. They were then divided into groups based on severity (mild-moderate and severe-critical) and outcome (survive and non-survive). The analysis included univariate and bivariate testing, including hazard ratio examination. ResultsClinical symptoms (headache, shortness of breath), pneumonia on chest X-ray, comorbidities (immune disorders, cerebrovascular disease), physical examination (unconsciousness, increased respiratory rate), and laboratory test (elevated C-reactive protein/CRP) all had an impact on patient survival. Meanwhile, similar patterns also observed on the severity-affecting factors, in addition to some variables such as abdominal pain, onset, systolic blood pressure, urea, creatinine, and procalcitonin. The NETs itself did not have any statistically significant role in the severity and survival of COVID-19 patients. ConclusionsClinical and laboratory variables played a crucial role in the prognostic and severity determination of COVID-19 patients, while NETs did not contribute to it.