NETosis induction reflects COVID-19 severity and long COVID: insights from a 2-center patient cohort study in Israel.

BACKGROUND: COVID-19 severity and its late complications continue to be poorly understood. Neutrophil extracellular traps (NETs) form in acute COVID-19, likely contributing to morbidity and mortality. OBJECTIVES: This study evaluated immunothrombosis markers in a comprehensive cohort of acute and recovered COVID-19 patients, including the association of NETs with long COVID. METHODS: One-hundred-seventy-seven patients were recruited from clinical cohorts at 2 Israeli centers: acute COVID-19 (mild/moderate, severe/critical), convalescent COVID-19 (recovered and long COVID), along with 54 non-COVID controls. Plasma was examined for markers of platelet activation, coagulation, and NETs. Ex vivo NETosis induction capability was evaluated after neutrophil incubation with patient plasma. RESULTS: Soluble P-selectin, factor VIII, von Willebrand factor, and platelet factor 4 were significantly elevated in patients with COVID-19 versus controls. Myeloperoxidase (MPO)-DNA complex levels were increased only in severe COVID-19 and did not differentiate between COVID-19 severities or correlate with thrombotic markers. NETosis induction levels strongly correlated with illness severity/duration, platelet activation markers, and coagulation factors, and were significantly reduced upon dexamethasone treatment and recovery. Patients with long COVID maintained higher NETosis induction, but not NET fragments, compared to recovered convalescent patients. CONCLUSIONS: Increased NETosis induction can be detected in patients with long COVID. NETosis induction appears to be a more sensitive NET measurement than MPO-DNA levels in COVID-19, differentiating between disease severity and patients with long COVID. Ongoing NETosis induction capability in long COVID may provide insights into pathogenesis and serve as a surrogate marker for persistent pathology. This study emphasizes the need to explore neutrophil-targeted therapies in acute and chronic COVID-19.

Regular Physical Activity as a Potential Risk Factor for Erosive Lesions in Adolescents.

Tooth erosion is becoming an increasingly common dental problem among teenagers. The study aimed to determine risk factors for erosive lesions in young sports professionals. Participants were 155 students-102 physically active and 53 controls. The method included dental examination (including Basic Erosive Wear Examination) and a questionnaire concerning sports activity, dietary and hygienic habits. The sporting activity significantly correlated with erosive lesions (RSpearman = 0.344). The regression model incorporating the kind of sports activity, special diet and (non-)drinking water was statistically significant (p = 0.922 for the Hosmer-Lemeshow test) and strong enough to predict erosive lesions in young athletes (AUC = 0.758). Water sports professionals were almost 14 times more likely to suffer from erosive lesions than control students. Drinking water as the main beverage decreased the odds by about 70%. The graphical interpretation of multidimensional correspondence analysis confirms the predictive value of these factors. The kind of sports activity adjusted by the main beverage and a special diet was the best variable to predict erosive lesions among teenagers. Early proper diagnosis with defined risk factors leads to better prevention and successful treatment.