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The interplay between neutrophils, complement, and microthrombi in COVID-19

Yu Zuo1, Yogendra Kanthi2, Jason S Knight1

  • 1Division of Rheumatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.

Best Practice & Research. Clinical Rheumatology
|February 2, 2021
PubMed

Insights

Severe COVID-19 involves a thromboinflammatory storm driven by neutrophils and complement. Understanding these innate immune pathways is crucial for developing new treatments against this global health challenge.

Area of Science:

  • Immunology
  • Infectious Diseases
  • Pathology

Background:

  • Coronavirus disease 2019 (COVID-19) presents a significant global health burden.
  • Severe COVID-19 is characterized by a thromboinflammatory response, involving innate immunity.
  • Current treatments primarily focus on supportive care due to a lack of targeted therapies.

Purpose of the Study:

  • To review the complex interplay between neutrophils, neutrophil extracellular traps (NETs), and complement in COVID-19 immunopathology.
  • To highlight potential therapeutic strategies targeting these innate immune pathways in severe COVID-19.

Main Methods:

  • Literature review focusing on the roles of neutrophils, NETs, and complement in COVID-19.
  • Analysis of clinical manifestations such as acute respiratory distress syndrome and thrombotic microangiopathy.
  • Synthesis of current understanding of COVID-19 immunopathology.

Main Results:

  • Neutrophils and complement are identified as key drivers of the innate immune response in severe COVID-19.
  • The formation of neutrophil extracellular traps (NETs) is implicated in the thromboinflammatory storm.
  • These pathways contribute to severe clinical outcomes including ARDS and thrombotic microangiopathy.

Conclusions:

  • The interplay of neutrophils, NETs, and complement is central to severe COVID-19 pathogenesis.
  • Targeting these innate immune components offers promising therapeutic avenues.
  • Further research into these pathways is essential for effective COVID-19 treatment strategies.

Keywords:
COVID-19ComplementInnate immunityNETsNeutrophil extracellular trapsSARS-CoV-2Thrombotic microangiopathy

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