Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Elevated NET, Calprotectin and Neopterin Levels Discriminate between Disease Activity of COVID-19 as Evidenced by Need of Hospitalization for Patients in Northern Italy

Geir Hetland
ORCID logo ,
Magne Kristoffer Fagerhol
ORCID logo ,
Mohammad Reza Mirlashari
,
Lise Sofie Haug Nissen-Meyer
,
Stefania Croci
ORCID logo ,
Paola Adele Lonati
,
Martina Bonacini
ORCID logo ,
Carlo Salvarani
,
Chiara Marvisi
,
Caterina Bodio
ORCID logo ,
Francesco Muratore
ORCID logo ,
Maria Orietta Borghi
ORCID logo ,
Pier Luigi Meroni
* ORCID logo
Version 1 : Received: 8 March 2024 / Approved: 11 March 2024 / Online: 12 March 2024 (13:38:10 CET)

A peer-reviewed article of this Preprint also exists.

Hetland, G.; Fagerhol, M.K.; Mirlashari, M.R.; Nissen-Meyer, L.S.H.; Croci, S.; Lonati, P.A.; Bonacini, M.; Salvarani, C.; Marvisi, C.; Bodio, C.; Muratore, F.; Borghi, M.O.; Meroni, P.L. Elevated NET, Calprotectin, and Neopterin Levels Discriminate between Disease Activity in COVID-19, as Evidenced by Need for Hospitalization among Patients in Northern Italy. Biomedicines 2024, 12, 766. Hetland, G.; Fagerhol, M.K.; Mirlashari, M.R.; Nissen-Meyer, L.S.H.; Croci, S.; Lonati, P.A.; Bonacini, M.; Salvarani, C.; Marvisi, C.; Bodio, C.; Muratore, F.; Borghi, M.O.; Meroni, P.L. Elevated NET, Calprotectin, and Neopterin Levels Discriminate between Disease Activity in COVID-19, as Evidenced by Need for Hospitalization among Patients in Northern Italy. Biomedicines 2024, 12, 766.

Abstract

Coronavirus disease 2019 (COVID-19) displays clinical heterogeneity, but little information is available for patients with mild or very early disease. We aimed to characterize biomarkers that are useful in discriminating the hospitalization risk in a COVID-19 cohort from Northern Italy during the first pandemic wave. We enrolled and followed for four weeks 76 symptomatic SARS-CoV-2 positive patients and age/sex-matched healthy controls. Patients with mild disease were discharged (n.42), and the remaining were hospitalized (n.34). Blood was collected before any anti-inflammatory/immunosuppressive therapy and assessed for soluble C5b-9/C5a, H3-neutrophil extracellular traps (NET), calprotectin, DNase plasma levels by ELISA, and a panel of pro-inflammatory cytokines by ELLA. Calprotectin and NET levels discriminate between hospitalized and non-hospitalized patients, while DNase negatively correlates with NET levels; there are positive correlations between calprotectin and both NET and neopterin levels. Neopterin levels increase in patients at the beginning of the disease and more in hospitalized than non-hospitalized ones. C5a and sC5b-9, and other acute phase proteins correlate with neopterin, calprotectin, and DNase. Both NET and neopterin levels negatively correlate with platelet count. We show that calprotectin, NET, and neopterin are important proinflammatory parameters potentially useful in discriminating between COVID-19 patients at risk for hospitalization.

Keywords

neutrophil extracellular traps; calprotectin; neopterin; complement; cytokines; COVID-19

Subject

Biology and Life Sciences, Life Sciences

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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