{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:44:53Z","timestamp":1790390693367,"version":"4.1.0"},"reference-count":24,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T00:00:00Z","timestamp":1609977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>Coronavirus Disease 2019 (COVID-19), a disease caused by the betacoronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has only recently emerged, while <jats:italic>Mycobacterium leprae<\/jats:italic>, the etiological agent of leprosy, has endured for more than 2,000 years. As soon as the initial reports of COVID-19 became public, several entities, including the Brazilian Leprosy Society, warned about the possible impact of COVID-19 on leprosy patients. It has been verified that COVID-19 carriers can be either asymptomatic or present varying degrees of severe respiratory failure in association with cytokine storm and death, among other diseases. Severe COVID-19 patients show increased numbers of neutrophils and serum neutrophil extracellular trap (NET) markers, in addition to alterations in the neutrophil-to-lymphocyte ratio (NLR). The absence of antiviral drugs and the speed of COVID-19 transmission have had a major impact on public health systems worldwide, leading to the almost total collapse of many national and local healthcare services. Leprosy, an infectious neurological and dermatological illness, is widely considered to be the most frequent cause of physical disabilities globally. The chronic clinical course of the disease may be interrupted by acute inflammatory episodes, named leprosy reactions. These serious immunological complications, characterized by cytokine storms, are responsible for amplifying peripheral nerve damage. From 30% to 40% of all multibacillary leprosy (MB) patients experience erythema nodosum leprosum (ENL), a neutrophilic immune-mediated condition. ENL patients often present these same COVID-19-like symptoms, including high levels of serum NET markers, altered NLR, and neutrophilia. Moreover, the consequences of a <jats:italic>M<\/jats:italic>. <jats:italic>leprae<\/jats:italic>\u2013SARS-CoV-2 coinfection have yet to be fully investigated. The goal of the present viewpoint is to describe some of the similarities that may be found between COVID-19 and leprosy disease in the context of neutrophilic biology.<\/jats:p>","DOI":"10.1371\/journal.pntd.0009019","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T19:00:31Z","timestamp":1610046031000},"page":"e0009019","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["COVID-19, leprosy, and neutrophils"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0865-133X","authenticated-orcid":true,"given":"Veronica","family":"Schmitz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2245-0841","authenticated-orcid":true,"given":"J\u00e9ssica Brand\u00e3o","family":"dos Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,1,7]]},"reference":[{"key":"pntd.0009019.ref001","article-title":"Covid-19\u2014Navigating the Uncharted","author":"AS Fauci","year":"2020","journal-title":"N Engl J Med"},{"key":"pntd.0009019.ref002","doi-asserted-by":"crossref","first-page":"e1006997","DOI":"10.1371\/journal.ppat.1006997","article-title":"Ancient genomes reveal a high diversity of Mycobacterium leprae in medieval Europe","volume":"14","author":"VJ Schuenemann","year":"2018","journal-title":"PLoS Pathog"},{"key":"pntd.0009019.ref003","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1038\/s41586-020-2577-1","article-title":"Discovery of SARS-CoV-2 antiviral drugs through large-scale compound repurposing","volume":"586","author":"L Riva","year":"2020","journal-title":"Nature"},{"key":"pntd.0009019.ref004","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.smim.2018.06.003","article-title":"Correlates of immune exacerbations in leprosy","volume":"39","author":"A Geluk","year":"2018","journal-title":"Semin Immunol"},{"key":"pntd.0009019.ref005","doi-asserted-by":"crossref","first-page":"e0008460","DOI":"10.1371\/journal.pntd.0008460","article-title":"Will cases of leprosy reaction increase with COVID-19 infection?","volume":"14","author":"DE Antunes","year":"2020","journal-title":"PLoS Negl Trop Dis."},{"key":"pntd.0009019.ref006","doi-asserted-by":"crossref","first-page":"jdv.16899","DOI":"10.1111\/jdv.16899","article-title":"Clinical Characteristics and Outcomes in Patients With COVID-2019 and Leprosy","author":"VS Santos","year":"2020","journal-title":"J Eur Acad Dermatol Venereol."},{"key":"pntd.0009019.ref007","first-page":"ijlh.13291","article-title":"Clinical and hematological characteristics of 88 patients with COVID-19","author":"H Zhang","year":"2020","journal-title":"Int J Lab Hematol"},{"key":"pntd.0009019.ref008","doi-asserted-by":"crossref","first-page":"2620","DOI":"10.1172\/JCI137244","article-title":"Clinical and immunological features of severe and moderate coronavirus disease 2019","volume":"130","author":"G Chen","year":"2020","journal-title":"J Clin Invest"},{"key":"pntd.0009019.ref009","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus\u2013Infected Pneumonia in Wuhan, China","volume":"323","author":"D Wang","year":"2020","journal-title":"JAMA"},{"key":"pntd.0009019.ref010","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1038\/s41591-020-0965-6","article-title":"Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections","volume":"26","author":"Q-X Long","year":"2020","journal-title":"Nat Med"},{"key":"pntd.0009019.ref011","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1038\/s41423-020-0402-2","article-title":"Functional exhaustion of antiviral lymphocytes in COVID-19 patients","volume":"17","author":"M Zheng","journal-title":"Cell Mol Immunol. 2020"},{"key":"pntd.0009019.ref012","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1093\/cid\/ciaa248","article-title":"Dysregulation of Immune Response in Patients With Coronavirus 2019 (COVID-19) in Wuhan, China","volume":"71","author":"C Qin","year":"2020","journal-title":"Clin Infect Dis"},{"key":"pntd.0009019.ref013","doi-asserted-by":"crossref","first-page":"e20200652","DOI":"10.1084\/jem.20200652","article-title":"Targeting potential drivers of COVID-19: Neutrophil extracellular traps","volume":"217","author":"BJ Barnes","year":"2020","journal-title":"J Exp Med"},{"key":"pntd.0009019.ref014","article-title":"A neutrophil activation signature predicts critical illness and mortality in COVID-19","author":"ML Meizlish","year":"2020","journal-title":"medRxiv"},{"key":"pntd.0009019.ref015","article-title":"Neutrophil extracellular traps in COVID-19","author":"Y Zuo","year":"2020","journal-title":"JCI Insight"},{"key":"pntd.0009019.ref016","first-page":"5","article-title":"COVID-19 Hyperinflammation: What about Neutrophils?","author":"A Didangelos","year":"2020","journal-title":"mSphere"},{"key":"pntd.0009019.ref017","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1590\/S0036-46651998000600005","article-title":"Reactional states in multibacillary Hansen disease patients during multidrug therapy","volume":"40","author":"JA Nery","year":"1998","journal-title":"Rev Inst Med Trop S\u00e3o Paulo"},{"key":"pntd.0009019.ref018","first-page":"8","article-title":"A Systematic Review of Immunological Studies of Erythema Nodosum Leprosum","author":"A Polycarpou","year":"2017","journal-title":"Front Immunol"},{"key":"pntd.0009019.ref019","doi-asserted-by":"crossref","first-page":"2657","DOI":"10.3390\/ijms21072657","article-title":"A Review of SARS-CoV-2 and the Ongoing Clinical Trials","volume":"21","author":"Y-F Tu","year":"2020","journal-title":"Int J Mol Sci"},{"key":"pntd.0009019.ref020","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1086\/650318","article-title":"Integrated pathways for neutrophil recruitment and inflammation in leprosy","volume":"201","author":"DJ Lee","year":"2010","journal-title":"J Infect Dis"},{"key":"pntd.0009019.ref021","article-title":"Reanalysis and integration of public microarray datasets reveals novel host genes modulated in leprosy","author":"T Leal-Calvo","year":"2020","journal-title":"Mol Genet Genomics MGG"},{"key":"pntd.0009019.ref022","first-page":"e03369","article-title":"Diagnostic value of neutrophil-to-lymphocyte ratio in patients with leprosy reactions","volume":"6","author":"LT Gomes","journal-title":"Heliyon. 2020"},{"key":"pntd.0009019.ref023","doi-asserted-by":"crossref","first-page":"47","DOI":"10.4049\/immunohorizons.1900088","article-title":"Erythema Nodosum Leprosum Neutrophil Subset Expressing IL-10R1 Transmigrates into Skin Lesions and Responds to IL-10","volume":"4","author":"FS Pacheco","year":"2020","journal-title":"Immunohorizons"},{"key":"pntd.0009019.ref024","doi-asserted-by":"crossref","first-page":"e0007368","DOI":"10.1371\/journal.pntd.0007368","article-title":"Neutrophil extracellular traps contribute to the pathogenesis of leprosy type 2 reactions","volume":"13","author":"CO da Silva","year":"2019","journal-title":"PLoS Negl Trop Dis"}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0009019","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T19:00:35Z","timestamp":1610046035000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0009019"}},"subtitle":[],"editor":[{"given":"Charlotte","family":"Avanzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,1,7]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1,7]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0009019","relation":{},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,7]]}}}