Aside from the increased number of activated neutrophils, emerging data suggest that excessive neutrophil extracellular traps (NETs) are in part responsible for extensive vascular injury, multi system inflammatory syndrome and COVID toes during COVID-19 infection. With this study, the authors report the potential pathogenic role of NETs and demonstrate impaired NET degradation in children and adults during COVID-19 infection.This multicenter study was conducted in collaboration with several other laboratories around the world.

What is exciting about this article?

The ongoing COVID-19 global pandemic has claimed more than 5 million lives worldwide. A better understanding of the mechanism of COVID-19 infection will enable the development of new and effective therapeutics against this RNA virus and its variants. This report demonstrated a putative correlation between the level of circulating NETs and symptomatic infection with variants of SARS-CoV-2, both in adults and children. Additionally, clarifying the relationship between the presence of NETs or undegradable NETs outside of the lungs and COVID-19 infection might help improve the understanding of disease prognosis even after a long period of COVID-19 infection.

How does this fit into the larger NIAMS portfolio?

Dr. Kaplan’s research focuses on finding abnormalities in neutrophils and understanding the role of NETs in systemic autoimmune disorders. This study found a correlation between circulating NETs and symptomatic infection with SARS-CoV-2 variants in both children and adults.

Grant support


Research Areas:

Autoimmunity Cell Biology Clinical Research Molecular Biology and Biochemistry Systems Biology


Multicenter analysis of neutrophil extracellular trap dysregulation in adult and pediatric COVID-19.

Carmona-Rivera C, Zhang Y, Dobbs K, Markowitz TE, Dalgard CL, Oler AJ, Claybaugh DR, Draper D, Truong M, Delmonte OM, Licciardi F, Ramenghi U, Crescenzio N, Imberti L, Sottini A, Quaresima V, Fiorini C, Discepolo V, Lo Vecchio A, Guarino A, Pierri L, Catzola A, Biondi A, Bonfanti P, Poli Harlowe MC, Espinosa Y, Astudillo C, Rey-Jurado E, Vial C, de la Cruz J, Gonzalez R, Pinera C, Mays JW, Ng A, Platt A, NIH COVID Autopsy Consortium, COVID STORM Clinicians, Drolet B, Moon J, Cowen EW, Kenney H, Weber SE, Castagnoli R, Magliocco M, Stack MA, Montealegre G, Barron K, Fink DL, Kuhns DB, Hewitt SM, Arkin LM, Chertow DS, Su HC, Notarangelo LD, Kaplan MJ
JCI Insight.
2022 Aug 22;
doi: 10.1172/jci.insight.160332
PMID: 35852866

Research reported in this publication was supported by the Intramural Research Program of the NIHʼs National Institute of Arthritis and Musculoskeletal and Skin Diseases.