SARS-CoV-2 infection poses a major threat to the lungs and multiple other organs, occasionally causing death. Until effective vaccines are developed to curb the pandemic, it is paramount to define the mechanisms and develop protective therapies to prevent organ dysfunction in patients with COVID-19. Individuals that develop severe manifestations have signs of dysregulated innate and adaptive immune responses. Emerging evidence implicates neutrophils and the disbalance between neutrophil extracellular trap (NET) formation and degradation plays a central role in the pathophysiology of inflammation, coagulopathy, organ damage, and immunothrombosis that characterize severe cases of COVID-19. Here, we discuss the evidence supporting a role for NETs in COVID-19 manifestations and present putative mechanisms, by which NETs promote tissue injury and immunothrombosis. We present therapeutic strategies, which have been successful in the treatment of immunο-inflammatory disorders and which target dysregulated NET formation or degradation, as potential approaches that may benefit patients with severe COVID-19.

SARS-CoV-2 感染对肺部和其他多个器官构成重大威胁，偶尔会导致死亡。在开发出有效的疫苗来遏制大流行之前，确定机制并开发保护性疗法以预防 COVID-19 患者的器官功能障碍至关重要。出现严重表现的个体有先天和适应性免疫反应失调的迹象。新出现的证据表明中性粒细胞和中性粒细胞胞外陷阱 (NET) 形成和降解之间的失衡在炎症、凝血病、器官损伤和免疫血栓形成的病理生理学中起着核心作用，这些都是 COVID-19 重症病例的特征。在这里，我们讨论了支持 NET 在 COVID-19 表现中发挥作用的证据，并提出了推定的机制，NET 促进组织损伤和免疫血栓形成。我们提出了治疗策略，这些策略已成功治疗免疫炎症性疾病，并以失调的 NET 形成或降解为目标，作为可能使重症 COVID-19 患者受益的潜在方法。