Tissue damage from neutrophil-induced oxidative stress in COVID-19

Nat Rev Immunol. 2020 Sep;20(9):515-516. doi: 10.1038/s41577-020-0407-1.

Abstract

The high neutrophil to lymphocyte ratio observed in critically ill patients with COVID-19 is associated with excessive levels of reactive oxygen species (ROS), which promote a cascade of biological events that drive pathological host responses. ROS induce tissue damage, thrombosis and red blood cell dysfunction, which contribute to COVID-19 disease severity. We suggest that free radical scavengers could be beneficial for the most vulnerable patients.

MeSH terms

  • Acetylcysteine / therapeutic use
  • Antioxidants / therapeutic use*
  • Betacoronavirus / drug effects
  • Betacoronavirus / immunology
  • Betacoronavirus / pathogenicity*
  • COVID-19
  • Coronavirus Infections / drug therapy*
  • Coronavirus Infections / immunology
  • Coronavirus Infections / virology
  • Cytokines / genetics
  • Cytokines / immunology
  • Drug Therapy, Combination
  • Extracellular Traps / drug effects
  • Extracellular Traps / immunology
  • Extracellular Traps / metabolism
  • Gene Expression Regulation
  • Glycine / analogs & derivatives
  • Glycine / therapeutic use
  • Host-Pathogen Interactions / drug effects
  • Humans
  • Immunity, Innate / drug effects
  • Lung / drug effects
  • Lung / immunology*
  • Lung / pathology
  • Lung / virology
  • Lymphocytes / drug effects
  • Lymphocytes / immunology
  • Lymphocytes / virology
  • NF-E2-Related Factor 2 / genetics
  • NF-E2-Related Factor 2 / immunology
  • NF-kappa B / genetics
  • NF-kappa B / immunology
  • Neutrophils / drug effects*
  • Neutrophils / immunology
  • Neutrophils / virology
  • Oxidative Stress / drug effects
  • Pandemics
  • Pneumonia, Viral / drug therapy*
  • Pneumonia, Viral / immunology
  • Pneumonia, Viral / virology
  • Proteinase Inhibitory Proteins, Secretory / therapeutic use
  • Reactive Oxygen Species / antagonists & inhibitors
  • Reactive Oxygen Species / immunology
  • Reactive Oxygen Species / metabolism
  • SARS-CoV-2
  • Severity of Illness Index
  • Sulfonamides / therapeutic use
  • Superoxide Dismutase / genetics
  • Superoxide Dismutase / immunology

Substances

  • Antioxidants
  • Cytokines
  • NF-E2-Related Factor 2
  • NF-kappa B
  • NFE2L2 protein, human
  • Proteinase Inhibitory Proteins, Secretory
  • Reactive Oxygen Species
  • Sulfonamides
  • sivelestat
  • SOD3 protein, human
  • Superoxide Dismutase
  • Glycine
  • Acetylcysteine