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Dysregulated neutrophil extracellular trap (NET) formation is one of several suggested pathophysiological mechanisms involved in the development of COVID-19 associated AKI. The corticosteroid dexamethasone was implemented as a standard treatment for severe COVID-19 as of June 2020. A sub-analysis of a prospective observational single center study was performed to evaluate the effect of corticosteroid treatment on AKI development and NET markers in critical cases of COVID-19.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Two hundred and ten adult patients admitted to intensive care at a tertiary level hospital due to respiratory failure or shock secondary to SARS-CoV-2-infection between March 13th 2020 and January 14th 2021 were included in the study. Ninety-seven of those did not receive corticosteroids. One hundred and thirteen patients were treated with corticosteroids [dexamethasone (<jats:italic>n<\/jats:italic>\u2009=\u200998) or equivalent treatment (<jats:italic>n<\/jats:italic>\u2009=\u200915)], but the incidence of AKI was assessed only in patients that received corticosteroids before any registered renal dysfunction (<jats:italic>n<\/jats:italic>\u2009=\u200963). Corticosteroids were associated with a lower incidence of AKI (19% vs 55.8%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Fewer patients demonstrated detectable concentrations of extracellular histones in plasma when treated with corticosteroids (8.7% vs 43.1%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Extracellular histones and in particular non-proteolyzed histones were observed more frequently with increasing AKI severity (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). MPO-DNA was found in lower concentrations in patients that received corticosteroids before established renal dysfunction (<jats:italic>p<\/jats:italic>\u2009=\u20090.03) and was found in higher concentrations in patients with AKI stage 3 (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). Corticosteroids did not ameliorate established AKI during the first week of treatment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Corticosteroid treatment in severe COVID-19 is associated with a lower incidence of AKI and reduced concentrations of NET markers in plasma.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40635-024-00670-3","type":"journal-article","created":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T12:01:50Z","timestamp":1727524910000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association of corticosteroid therapy with reduced acute kidney injury and lower NET markers in severe COVID-19: an observational study"],"prefix":"10.1186","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8769-7036","authenticated-orcid":false,"given":"Sara","family":"B\u00fclow Anderberg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joram","family":"Huckriede","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hultstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Larsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Femke","family":"de Vries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miklos","family":"Lipcsey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerry A. 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