Immune System Disequilibrium-Neutrophils, Their Extracellular Traps, and COVID-19-Induced Sepsis

Colm Keane; Matthew Coalter; Ignacio Martin-Loeches

doi:10.3389/fmed.2021.711397

Immune System Disequilibrium-Neutrophils, Their Extracellular Traps, and COVID-19-Induced Sepsis

Front Med (Lausanne). 2021 Aug 18:8:711397. doi: 10.3389/fmed.2021.711397. eCollection 2021.

Authors

Colm Keane^{1

2}, Matthew Coalter¹, Ignacio Martin-Loeches^{1

2}

Affiliations

¹ Department of Anaesthesia and Intensive Care, St. James's Hospital, Dublin, Ireland.
² Multidisciplinary Intensive Care Research Organization (MICRO), Trinity College Dublin, Dublin, Ireland.

Abstract

Equilibrium within the immune system can often determine the fate of its host. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic. Immune dysregulation remains one of the main pathophysiological components of SARS-CoV-2-associated organ injury, with over-activation of the innate immune system, and induced apoptosis of adaptive immune cells. Here, we provide an overview of the innate immune system, both in general and relating to COVID-19. We specifically discuss "NETosis," the process of neutrophil release of their extracellular traps, which may be a more recently described form of cell death that is different from apoptosis, and how this may propagate organ dysfunction in COVID-19. We complete this review by discussing Stem Cell Therapies in COVID-19 and emerging COVID-19 phenotypes, which may allow for more targeted therapy in the future. Finally, we consider the array of potential therapeutic targets in COVID-19, and associated therapeutics.

Keywords: COVID-19; NETosis; SARS-CoV-2; immune system; innate; neutrophil; neutrophil extracellular trap.

Publication types

Review