Neutrophil Extracellular Traps and Platelet Activation for Identifying Severe Episodes and Clinical Trajectories in COVID-19
The role of NETs and platelet activation in COVID-19 is scarcely known. We aimed to evaluate the role of NETs (citrullinated histone H3 [CitH3], cell-free DNA [cfDNA]) and platelet activation markers (soluble CD40 ligand [CD40L] and P-selectin) in estimating the hazard of different clinical trajecto...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/24/7/6690 |
| _version_ | 1797607743977160704 |
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| author | Paula González-Jiménez Raúl Méndez Ana Latorre Mónica Piqueras María Nieves Balaguer-Cartagena Antonio Moscardó Ricardo Alonso David Hervás Soledad Reyes Rosario Menéndez |
| author_facet | Paula González-Jiménez Raúl Méndez Ana Latorre Mónica Piqueras María Nieves Balaguer-Cartagena Antonio Moscardó Ricardo Alonso David Hervás Soledad Reyes Rosario Menéndez |
| author_sort | Paula González-Jiménez |
| collection | DOAJ |
| description | The role of NETs and platelet activation in COVID-19 is scarcely known. We aimed to evaluate the role of NETs (citrullinated histone H3 [CitH3], cell-free DNA [cfDNA]) and platelet activation markers (soluble CD40 ligand [CD40L] and P-selectin) in estimating the hazard of different clinical trajectories in patients with COVID-19. We performed a prospective study of 204 patients, categorized as outpatient, hospitalized and ICU-admitted. A multistate model was designed to estimate probabilities of clinical transitions across varying states, such as emergency department (ED) visit, discharge (outpatient), ward admission, ICU admission and death. Levels of cfDNA, CitH3 and P-selectin were associated with the severity of presentation and analytical parameters. The model showed an increased risk of higher levels of CitH3 and P-selectin for ED-to-ICU transitions (Hazard Ratio [HR]: 1.35 and 1.31, respectively), as well as an elevated risk of higher levels of P-selectin for ward-to-death transitions (HR: 1.09). Elevated levels of CitH3 (HR: 0.90), cfDNA (HR: 0.84) and P-selectin (HR: 0.91) decreased the probability of ward-to-discharge transitions. A similar trend existed for elevated levels of P-selectin and ICU-to-ward transitions (HR 0.40); In conclusion, increased NET and P-selectin levels are associated with more severe episodes and can prove useful in estimating different clinical trajectories. |
| first_indexed | 2024-03-11T05:33:55Z |
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| id | doaj.art-889e63e2d8af4f9eaea85b822aba6c27 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-11T05:33:55Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-889e63e2d8af4f9eaea85b822aba6c272023-11-17T16:54:40ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672023-04-01247669010.3390/ijms24076690Neutrophil Extracellular Traps and Platelet Activation for Identifying Severe Episodes and Clinical Trajectories in COVID-19Paula González-Jiménez0Raúl Méndez1Ana Latorre2Mónica Piqueras3María Nieves Balaguer-Cartagena4Antonio Moscardó5Ricardo Alonso6David Hervás7Soledad Reyes8Rosario Menéndez9Pneumology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, SpainPneumology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, SpainRespiratory Infections, Health Research Institute La Fe, 46026 Valencia, SpainMedicine Department, University of Valencia, 46010 Valencia, SpainPneumology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, SpainPlatelet Function Unit, Health Research Institute La Fe, 46026 Valencia, SpainLaboratory Department, La Fe University and Polytechnic Hospital, 46026 Valencia, SpainData Science, Biostatistics & Bioinformatics, Health Research Institute La Fe, 46026 Valencia, SpainPneumology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, SpainPneumology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, SpainThe role of NETs and platelet activation in COVID-19 is scarcely known. We aimed to evaluate the role of NETs (citrullinated histone H3 [CitH3], cell-free DNA [cfDNA]) and platelet activation markers (soluble CD40 ligand [CD40L] and P-selectin) in estimating the hazard of different clinical trajectories in patients with COVID-19. We performed a prospective study of 204 patients, categorized as outpatient, hospitalized and ICU-admitted. A multistate model was designed to estimate probabilities of clinical transitions across varying states, such as emergency department (ED) visit, discharge (outpatient), ward admission, ICU admission and death. Levels of cfDNA, CitH3 and P-selectin were associated with the severity of presentation and analytical parameters. The model showed an increased risk of higher levels of CitH3 and P-selectin for ED-to-ICU transitions (Hazard Ratio [HR]: 1.35 and 1.31, respectively), as well as an elevated risk of higher levels of P-selectin for ward-to-death transitions (HR: 1.09). Elevated levels of CitH3 (HR: 0.90), cfDNA (HR: 0.84) and P-selectin (HR: 0.91) decreased the probability of ward-to-discharge transitions. A similar trend existed for elevated levels of P-selectin and ICU-to-ward transitions (HR 0.40); In conclusion, increased NET and P-selectin levels are associated with more severe episodes and can prove useful in estimating different clinical trajectories.https://www.mdpi.com/1422-0067/24/7/6690COVID-19SARS-CoV-2platelet activationneutrophil extracellular traps |
| spellingShingle | Paula González-Jiménez Raúl Méndez Ana Latorre Mónica Piqueras María Nieves Balaguer-Cartagena Antonio Moscardó Ricardo Alonso David Hervás Soledad Reyes Rosario Menéndez Neutrophil Extracellular Traps and Platelet Activation for Identifying Severe Episodes and Clinical Trajectories in COVID-19 International Journal of Molecular Sciences COVID-19 SARS-CoV-2 platelet activation neutrophil extracellular traps |
| title | Neutrophil Extracellular Traps and Platelet Activation for Identifying Severe Episodes and Clinical Trajectories in COVID-19 |
| title_full | Neutrophil Extracellular Traps and Platelet Activation for Identifying Severe Episodes and Clinical Trajectories in COVID-19 |
| title_fullStr | Neutrophil Extracellular Traps and Platelet Activation for Identifying Severe Episodes and Clinical Trajectories in COVID-19 |
| title_full_unstemmed | Neutrophil Extracellular Traps and Platelet Activation for Identifying Severe Episodes and Clinical Trajectories in COVID-19 |
| title_short | Neutrophil Extracellular Traps and Platelet Activation for Identifying Severe Episodes and Clinical Trajectories in COVID-19 |
| title_sort | neutrophil extracellular traps and platelet activation for identifying severe episodes and clinical trajectories in covid 19 |
| topic | COVID-19 SARS-CoV-2 platelet activation neutrophil extracellular traps |
| url | https://www.mdpi.com/1422-0067/24/7/6690 |
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