Correspondence to Author: Yeliz Ogret¹^1,2*,Ayse Seda Akdemir^2,3 ,Seydanur Dogan¹,Selen Zeliha Mart Komurcu⁴, Merve Damla Korkmaz⁵, Ebru Kaya⁶, Sevim Yavas⁷, Ahmet Dirican⁸, Selcuk Dasdemir¹, Melek Ozturk Sezgin². 

¹ Department of Medical Biology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye.
² Department of Medical Biology, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Türkiye.
³ Department of Medical Biology, Faculty of Medicine, Karabuk University, Karabuk, Türkiye
⁴ Department of Microbiology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Türkiye.
⁵ Department of Physical Medicine and Rehabilitation, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Türkiye.
⁶ Department of Anesthesiology and Reanimation, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Türkiye.
⁷ Infectious Diseases Clinic, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Türkiye.
⁸ Department of Biostatistics, Cerrahpaşa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Türkiye.

DOI: 10.52338/immunology.2025.4952

Abstract:

Objective:Various cellular pathologies in leukocytes contribute to the pathology of COVID-19 caused by SARS-CoV-2 infection. In this study, we aimed to determine the prognostic significance of netotic and pyroptotic cell deaths in relation to disease severity in COVID-19 pathophysiology
Materials and Methods: Serum samples were collected from a total of 150 patients with mild, moderate, and severe COVID-19, as defined by the COVID-19 diagnosis and treatment guidelines, along with 89 healthy individuals. Circulating markers of netosis and pyroptosis, including neutrophil elastase (NE), citrullinated histone H3 (CitH-H3), myeloperoxidase (MPO), cell-free DNA (cfDNA), gasdermin D (GSDMD), IL-18, and IL-8, were analyzed using the ELISA method. The effects of netosis and pyroptosis markers on disease severity and clinical parameters were comparatively evaluated, and their associations with inflammation, thrombosis, and fibrinolysis were also investigated.
Results:: NE, GSDMD, IL-18, MPO, CITH3, D-dimer, leukocyte and lymphocyte levels, as well as inflammatory markers (CRP, ferritin), showed a significantly elevated in severe COVİD-19 patients compare to the other groups.
Conclusion: Our findings indicate that circulating netosis and pyroptosis markers in SARS-CoV-2 infections correlate with inflammation, dysregulated hemostasis, and fibrinolysis markers, playing a role in disease prognosis. These associations may provide potential therapeutic targets for the treatment of severe COVID-19 cases.

Keywords:SARS-CoV-2, netosis, pyroptosis

Citation:

Yeliz Ogret, Association Of Disease Severity And Clinical Outcomes With Circulating Markers Of Netosis And Pyroptosis In SARS-COV-2 Infection. Journal of Immunology 2025.