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A significant proportion of patients experience persistent or new symptoms after recovery, referred to as post-COVID syndrome (PCS), which may be associated with NET release persistence. This study aimed to investigate whether NET-related biomarkers remain elevated after acute SARS-CoV-2 infection and to explore their association with PCS. We conducted an analytical descriptive cohort study including patients with acute COVID-19 (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200935), PCS (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200935), and a pre-pandemic healthy control group (PPC;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200935). Serum samples from participants were used to measure NET biomarkers, including MPO-DNA complexes, elastase-DNA complexes, and MPO levels. The capacity to induce NETosis\n                    <jats:italic>in vitro<\/jats:italic>\n                    was evaluated by incubating neutrophils with participant serum. Additionally, soluble immune markers, including cytokines, anti-SARS-CoV-2 antibodies, and autoantibodies, were assessed. A NETosis-based model was developed using NET biomarkers to distinguish between acute COVID-19 or PCS patients and PPC individuals. Our findings revealed a significant increase in NET biomarkers during acute COVID-19 that persisted in PCS. This pattern was consistent with the\n                    <jats:italic>in vitro<\/jats:italic>\n                    study, where sera from PCS patients induced NET release. Additionally, NET biomarkers correlated with neutrophil counts, cytokines, autoantibodies, and inflammatory markers during acute COVID-19 and PCS. The multivariate model of NET biomarkers exhibited a high accuracy in distinguishing acute COVID-19 with an area under the curve (AUC) of 0.99 (CI\u2009=\u20090.98\u20131.00) and PCS patients with an AUC of 0.91 (CI\u2009=\u20090.84\u20130.99) from PPC. These findings suggest that persistent NETosis may contribute to PCS pathophysiology, highlighting NETs as potential biomarkers and therapeutic targets in post-viral syndromes.\n                  <\/jats:p>","DOI":"10.1007\/s10875-026-01980-9","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T04:03:19Z","timestamp":1770004999000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["NET Biomarkers in COVID-19 and Post-COVID Syndrome: a Comprehensive Analysis"],"prefix":"10.1007","volume":"46","author":[{"given":"Diana M.","family":"Monsalve","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Numpaque-Morales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Rojas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeny","family":"Acosta-Ampudia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Ram\u00edrez-Santana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"1980_CR1","unstructured":"Organization WH. 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