{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:09:15Z","timestamp":1791929355730,"version":"4.3.4"},"reference-count":49,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T00:00:00Z","timestamp":1661212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Research Foundation (DFG)","award":["2886 PANDORA Project-No. B3"],"award-info":[{"award-number":["2886 PANDORA Project-No. B3"]}]},{"name":"German Research Foundation (DFG)","award":["CRC1181-261193037 (C03)"],"award-info":[{"award-number":["CRC1181-261193037 (C03)"]}]},{"name":"German Research Foundation (DFG)","award":["TRR241 (B04)"],"award-info":[{"award-number":["TRR241 (B04)"]}]},{"name":"German Research Foundation (DFG)","award":["H2020-FETOPEN-2018-2019-2020-01"],"award-info":[{"award-number":["H2020-FETOPEN-2018-2019-2020-01"]}]},{"name":"German Research Foundation (DFG)","award":["861878"],"award-info":[{"award-number":["861878"]}]},{"name":"German Research Foundation (DFG)","award":["97744"],"award-info":[{"award-number":["97744"]}]},{"name":"German Research Foundation (DFG)","award":["MIIC-2021"],"award-info":[{"award-number":["MIIC-2021"]}]},{"name":"German Research Foundation (DFG)","award":["R-939149"],"award-info":[{"award-number":["R-939149"]}]},{"name":"German Research Foundation (DFG)","award":["R\u00d6-960604"],"award-info":[{"award-number":["R\u00d6-960604"]}]},{"name":"German Research Foundation (DFG)","award":["SLS-590231"],"award-info":[{"award-number":["SLS-590231"]}]},{"name":"German Research Foundation (DFG)","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"name":"German Research Foundation (DFG)","award":["FAI-2020-0663"],"award-info":[{"award-number":["FAI-2020-0663"]}]},{"name":"German Research Foundation (DFG)","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"name":"Volkswagen-Stiftung","award":["2886 PANDORA Project-No. B3"],"award-info":[{"award-number":["2886 PANDORA Project-No. B3"]}]},{"name":"Volkswagen-Stiftung","award":["CRC1181-261193037 (C03)"],"award-info":[{"award-number":["CRC1181-261193037 (C03)"]}]},{"name":"Volkswagen-Stiftung","award":["TRR241 (B04)"],"award-info":[{"award-number":["TRR241 (B04)"]}]},{"name":"Volkswagen-Stiftung","award":["H2020-FETOPEN-2018-2019-2020-01"],"award-info":[{"award-number":["H2020-FETOPEN-2018-2019-2020-01"]}]},{"name":"Volkswagen-Stiftung","award":["861878"],"award-info":[{"award-number":["861878"]}]},{"name":"Volkswagen-Stiftung","award":["97744"],"award-info":[{"award-number":["97744"]}]},{"name":"Volkswagen-Stiftung","award":["MIIC-2021"],"award-info":[{"award-number":["MIIC-2021"]}]},{"name":"Volkswagen-Stiftung","award":["R-939149"],"award-info":[{"award-number":["R-939149"]}]},{"name":"Volkswagen-Stiftung","award":["R\u00d6-960604"],"award-info":[{"award-number":["R\u00d6-960604"]}]},{"name":"Volkswagen-Stiftung","award":["SLS-590231"],"award-info":[{"award-number":["SLS-590231"]}]},{"name":"Volkswagen-Stiftung","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"name":"Volkswagen-Stiftung","award":["FAI-2020-0663"],"award-info":[{"award-number":["FAI-2020-0663"]}]},{"name":"Volkswagen-Stiftung","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["2886 PANDORA Project-No. B3"],"award-info":[{"award-number":["2886 PANDORA Project-No. B3"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["CRC1181-261193037 (C03)"],"award-info":[{"award-number":["CRC1181-261193037 (C03)"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["TRR241 (B04)"],"award-info":[{"award-number":["TRR241 (B04)"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["H2020-FETOPEN-2018-2019-2020-01"],"award-info":[{"award-number":["H2020-FETOPEN-2018-2019-2020-01"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["861878"],"award-info":[{"award-number":["861878"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["97744"],"award-info":[{"award-number":["97744"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["MIIC-2021"],"award-info":[{"award-number":["MIIC-2021"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["R-939149"],"award-info":[{"award-number":["R-939149"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["R\u00d6-960604"],"award-info":[{"award-number":["R\u00d6-960604"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["SLS-590231"],"award-info":[{"award-number":["SLS-590231"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["FAI-2020-0663"],"award-info":[{"award-number":["FAI-2020-0663"]}]},{"name":"MIIC (Medical Infection and Inflammation Center, Link\u00f6ping University and Region \u00d6sterg\u00f6tland)","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["2886 PANDORA Project-No. B3"],"award-info":[{"award-number":["2886 PANDORA Project-No. B3"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["CRC1181-261193037 (C03)"],"award-info":[{"award-number":["CRC1181-261193037 (C03)"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["TRR241 (B04)"],"award-info":[{"award-number":["TRR241 (B04)"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["H2020-FETOPEN-2018-2019-2020-01"],"award-info":[{"award-number":["H2020-FETOPEN-2018-2019-2020-01"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["861878"],"award-info":[{"award-number":["861878"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["97744"],"award-info":[{"award-number":["97744"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["MIIC-2021"],"award-info":[{"award-number":["MIIC-2021"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["R-939149"],"award-info":[{"award-number":["R-939149"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["R\u00d6-960604"],"award-info":[{"award-number":["R\u00d6-960604"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["SLS-590231"],"award-info":[{"award-number":["SLS-590231"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["2021"],"award-info":[{"award-number":["2021"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["FAI-2020-0663"],"award-info":[{"award-number":["FAI-2020-0663"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007949","name":"Swedish Rheumatism Association","doi-asserted-by":"publisher","award":["2021"],"award-info":[{"award-number":["2021"]}],"id":[{"id":"10.13039\/501100007949","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["2886 PANDORA Project-No. B3"],"award-info":[{"award-number":["2886 PANDORA Project-No. B3"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["CRC1181-261193037 (C03)"],"award-info":[{"award-number":["CRC1181-261193037 (C03)"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["TRR241 (B04)"],"award-info":[{"award-number":["TRR241 (B04)"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["H2020-FETOPEN-2018-2019-2020-01"],"award-info":[{"award-number":["H2020-FETOPEN-2018-2019-2020-01"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["861878"],"award-info":[{"award-number":["861878"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["97744"],"award-info":[{"award-number":["97744"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["MIIC-2021"],"award-info":[{"award-number":["MIIC-2021"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["R-939149"],"award-info":[{"award-number":["R-939149"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["R\u00d6-960604"],"award-info":[{"award-number":["R\u00d6-960604"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["SLS-590231"],"award-info":[{"award-number":["SLS-590231"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["FAI-2020-0663"],"award-info":[{"award-number":["FAI-2020-0663"]}]},{"name":"Region \u00d6sterg\u00f6tland (ALF Grants)","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["2886 PANDORA Project-No. B3"],"award-info":[{"award-number":["2886 PANDORA Project-No. B3"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["CRC1181-261193037 (C03)"],"award-info":[{"award-number":["CRC1181-261193037 (C03)"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["TRR241 (B04)"],"award-info":[{"award-number":["TRR241 (B04)"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["H2020-FETOPEN-2018-2019-2020-01"],"award-info":[{"award-number":["H2020-FETOPEN-2018-2019-2020-01"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["861878"],"award-info":[{"award-number":["861878"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["97744"],"award-info":[{"award-number":["97744"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["MIIC-2021"],"award-info":[{"award-number":["MIIC-2021"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["R-939149"],"award-info":[{"award-number":["R-939149"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["R\u00d6-960604"],"award-info":[{"award-number":["R\u00d6-960604"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["SLS-590231"],"award-info":[{"award-number":["SLS-590231"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["2021"],"award-info":[{"award-number":["2021"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["FAI-2020-0663"],"award-info":[{"award-number":["FAI-2020-0663"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007687","name":"Swedish Society of Medicine","doi-asserted-by":"publisher","award":["2021"],"award-info":[{"award-number":["2021"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Gustafsson Foundation","award":["2886 PANDORA Project-No. B3"],"award-info":[{"award-number":["2886 PANDORA Project-No. B3"]}]},{"name":"Gustafsson Foundation","award":["CRC1181-261193037 (C03)"],"award-info":[{"award-number":["CRC1181-261193037 (C03)"]}]},{"name":"Gustafsson Foundation","award":["TRR241 (B04)"],"award-info":[{"award-number":["TRR241 (B04)"]}]},{"name":"Gustafsson Foundation","award":["H2020-FETOPEN-2018-2019-2020-01"],"award-info":[{"award-number":["H2020-FETOPEN-2018-2019-2020-01"]}]},{"name":"Gustafsson Foundation","award":["861878"],"award-info":[{"award-number":["861878"]}]},{"name":"Gustafsson Foundation","award":["97744"],"award-info":[{"award-number":["97744"]}]},{"name":"Gustafsson Foundation","award":["MIIC-2021"],"award-info":[{"award-number":["MIIC-2021"]}]},{"name":"Gustafsson Foundation","award":["R-939149"],"award-info":[{"award-number":["R-939149"]}]},{"name":"Gustafsson Foundation","award":["R\u00d6-960604"],"award-info":[{"award-number":["R\u00d6-960604"]}]},{"name":"Gustafsson Foundation","award":["SLS-590231"],"award-info":[{"award-number":["SLS-590231"]}]},{"name":"Gustafsson Foundation","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"name":"Gustafsson Foundation","award":["FAI-2020-0663"],"award-info":[{"award-number":["FAI-2020-0663"]}]},{"name":"Gustafsson Foundation","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["2886 PANDORA Project-No. B3"],"award-info":[{"award-number":["2886 PANDORA Project-No. B3"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["CRC1181-261193037 (C03)"],"award-info":[{"award-number":["CRC1181-261193037 (C03)"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["TRR241 (B04)"],"award-info":[{"award-number":["TRR241 (B04)"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["H2020-FETOPEN-2018-2019-2020-01"],"award-info":[{"award-number":["H2020-FETOPEN-2018-2019-2020-01"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["861878"],"award-info":[{"award-number":["861878"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["97744"],"award-info":[{"award-number":["97744"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["MIIC-2021"],"award-info":[{"award-number":["MIIC-2021"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["R-939149"],"award-info":[{"award-number":["R-939149"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["R\u00d6-960604"],"award-info":[{"award-number":["R\u00d6-960604"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["SLS-590231"],"award-info":[{"award-number":["SLS-590231"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["FAI-2020-0663"],"award-info":[{"award-number":["FAI-2020-0663"]}]},{"name":"King Gustaf V\u2019s 80-year Anniversary foundation","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["2886 PANDORA Project-No. B3"],"award-info":[{"award-number":["2886 PANDORA Project-No. B3"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["CRC1181-261193037 (C03)"],"award-info":[{"award-number":["CRC1181-261193037 (C03)"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["TRR241 (B04)"],"award-info":[{"award-number":["TRR241 (B04)"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["H2020-FETOPEN-2018-2019-2020-01"],"award-info":[{"award-number":["H2020-FETOPEN-2018-2019-2020-01"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["861878"],"award-info":[{"award-number":["861878"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["97744"],"award-info":[{"award-number":["97744"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["MIIC-2021"],"award-info":[{"award-number":["MIIC-2021"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["R-939149"],"award-info":[{"award-number":["R-939149"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["R\u00d6-960604"],"award-info":[{"award-number":["R\u00d6-960604"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["SLS-590231"],"award-info":[{"award-number":["SLS-590231"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["2021"],"award-info":[{"award-number":["2021"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["FAI-2020-0663"],"award-info":[{"award-number":["FAI-2020-0663"]}]},{"name":"King Gustaf V and Queen Victoria\u2019s Freemasons foundation","award":["2021"],"award-info":[{"award-number":["2021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>The severity of the coronavirus disease in 2019 (COVID-19) is strongly linked to a dysregulated immune response. This fuels the fear of severe disease in patients with autoimmune disorders continuously using immunosuppressive\/immunomodulating medications. One complication of COVID-19 is thromboembolism caused by intravascular aggregates of neutrophil extracellular traps (NETs) occluding the affected vessels. Like COVID-19, systemic lupus erythematosus (SLE) is characterized by, amongst others, an increased risk of thromboembolism. An imbalance between NET formation and clearance is suggested to play a prominent role in exacerbating autoimmunity and disease severity. Serologic evidence of exposure to SARS-CoV-2 has a minor impact on the SLE course in a Swedish cohort reportedly. Herein, we assessed NET formation in patients from this cohort by neutrophil elastase (NE) activity and the presence of cell-free DNA, MPO-DNA, and NE-DNA complexes and correlated the findings to the clinical parameters. The presence of NE-DNA complexes and NE activity differed significantly in pre-pandemic versus pandemic serum samples. The latter correlated significantly with the hemoglobin concentration, blood cell counts, and complement protein 3 and 4 levels in the pre-pandemic but only with the leukocyte count and neutrophil levels in the pandemic serum samples. Taken together, our data suggest a change, especially in the NE activity independent of exposure to SARS-CoV-2.<\/jats:p>","DOI":"10.3390\/cells11172619","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T21:05:12Z","timestamp":1661288712000},"page":"2619","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["NET Formation in Systemic Lupus Erythematosus: Changes during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2922-9370","authenticated-orcid":false,"given":"Jasmin","family":"Knopf","sequence":"first","affiliation":[{"name":"Department of Internal Medicine 3\u2014Rheumatology and Immunology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, 91054 Erlangen, Germany"},{"name":"Deutsches Zentrum f\u00fcr Immuntherapie (DZI), Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5622-866X","authenticated-orcid":false,"given":"Johanna","family":"Sj\u00f6wall","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection\/Infectious Diseases, Link\u00f6ping University, SE-581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7522-5069","authenticated-orcid":false,"given":"Martina","family":"Frodlund","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection\/Rheumatology, Link\u00f6ping University, SE-581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1908-5609","authenticated-orcid":false,"given":"Jorma","family":"Hinkula","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Division of Molecular Medicine and Virology, Link\u00f6ping University, SE-581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0258-2484","authenticated-orcid":false,"given":"Martin","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine 3\u2014Rheumatology and Immunology, Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, 91054 Erlangen, Germany"},{"name":"Deutsches Zentrum f\u00fcr Immuntherapie (DZI), Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg (FAU) and Universit\u00e4tsklinikum Erlangen, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0900-2048","authenticated-orcid":false,"given":"Christopher","family":"Sj\u00f6wall","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Clinical Sciences, Division of Inflammation and Infection\/Rheumatology, Link\u00f6ping University, SE-581 85 Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,23]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2022, June 22). WHO COVID-19 Dashboard. Available online: https:\/\/covid19.who.int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1016\/j.cell.2020.05.016","article-title":"A Global Effort to Define the Human Genetics of Protective Immunity to SARS-CoV-2 Infection","volume":"181","author":"Casanova","year":"2020","journal-title":"Cell"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/BOR.0000000000000776","article-title":"COVID-19 and autoimmune diseases","volume":"33","author":"Liu","year":"2021","journal-title":"Curr. Opin. Rheumatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e154886","DOI":"10.1172\/JCI154886","article-title":"The intersection of COVID-19 and autoimmunity","volume":"131","author":"Knight","year":"2021","journal-title":"J. Clin. Investig."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1126\/science.abc6027","article-title":"Impaired type I interferon activity and inflammatory responses in severe COVID-19 patients","volume":"369","author":"Hadjadj","year":"2020","journal-title":"Science"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"eabd1554","DOI":"10.1126\/sciimmunol.abd1554","article-title":"Immunophenotyping of COVID-19 and influenza highlights the role of type I interferons in development of severe COVID-19","volume":"5","author":"Lee","year":"2020","journal-title":"Sci. Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1038\/s41586-020-2588-y","article-title":"Longitudinal analyses reveal immunological misfiring in severe COVID-19","volume":"584","author":"Lucas","year":"2020","journal-title":"Nature"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.chom.2020.04.017","article-title":"Heightened Innate Immune Responses in the Respiratory Tract of COVID-19 Patients","volume":"27","author":"Zhou","year":"2020","journal-title":"Cell Host Microbe"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e000336","DOI":"10.1136\/lupus-2019-000336","article-title":"Type I interferons in host defence and inflammatory diseases","volume":"6","author":"Crow","year":"2019","journal-title":"Lupus Sci. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"724047","DOI":"10.3389\/fimmu.2021.724047","article-title":"SARS-CoV-2 Antibody Isotypes in Systemic Lupus Erythematosus Patients Prior to Vaccination: Associations with Disease Activity, Antinuclear Antibodies, and Immunomodulatory Drugs during the First Year of the Pandemic","volume":"12","author":"Azharuddin","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"19630","DOI":"10.1038\/s41598-020-76781-0","article-title":"The emerging role of neutrophil extracellular traps in severe acute respiratory syndrome coronavirus 2 (COVID-19)","volume":"10","author":"Arcanjo","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"102925","DOI":"10.1016\/j.ebiom.2020.102925","article-title":"Vascular occlusion by neutrophil extracellular traps in COVID-19","volume":"58","author":"Leppkes","year":"2020","journal-title":"eBioMedicine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e20201129","DOI":"10.1084\/jem.20201129","article-title":"SARS-CoV-2-triggered neutrophil extracellular traps mediate COVID-19 pathology","volume":"217","author":"Veras","year":"2020","journal-title":"J. Exp. Med."},{"key":"ref_14","first-page":"e138999","article-title":"Neutrophil extracellular traps in COVID-19","volume":"5","author":"Zuo","year":"2020","journal-title":"JCI Insight"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1080\/08916934.2018.1514496","article-title":"Active NET formation in Libman\u2013Sacks endocarditis without antiphospholipid antibodies: A dramatic onset of systemic lupus erythematosus","volume":"51","author":"Appelgren","year":"2018","journal-title":"Autoimmunity"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Yaykasli, K.O., Schauer, C., Mu\u00f1oz, L.E., Mahajan, A., Knopf, J., Schett, G., and Herrmann, M. (2021). Neutrophil Extracellular Trap-Driven Occlusive Diseases. Cells, 10.","DOI":"10.3390\/cells10092208"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3125","DOI":"10.1038\/s41418-021-00805-z","article-title":"Patients with COVID-19: In the dark-NETs of neutrophils","volume":"28","author":"Ackermann","year":"2021","journal-title":"Cell Death Differ."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2824","DOI":"10.3389\/fimmu.2019.02824","article-title":"Neutrophil Extracellular Traps in Autoimmunity and Allergy: Immune Complexes at Work","volume":"10","author":"Granger","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3522","DOI":"10.4049\/jimmunol.1102404","article-title":"Neutrophil Extracellular Traps That Are Not Degraded in Systemic Lupus Erythematosus Activate Complement Exacerbating the Disease","volume":"188","author":"Leffler","year":"2012","journal-title":"J. Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1136\/annrheumdis-2019-215434","article-title":"Genetic variations in A20 DUB domain provide a genetic link to citrullination and neutrophil extracellular traps in systemic lupus erythematosus","volume":"78","author":"Odqvist","year":"2019","journal-title":"Ann. Rheum. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"635436","DOI":"10.3389\/fmed.2021.635436","article-title":"Neutrophil Extracellular Traps in Systemic Lupus Erythematosus Stimulate IgG2 Production from B Lymphocytes","volume":"8","author":"Bertelli","year":"2021","journal-title":"Front. Med."},{"key":"ref_22","first-page":"73ra20","article-title":"Netting Neutrophils Are Major Inducers of Type I IFN Production in Pediatric Systemic Lupus Erythematosus","volume":"3","author":"Caielli","year":"2011","journal-title":"Sci. Transl. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"73ra19","DOI":"10.1126\/scitranslmed.3001180","article-title":"Neutrophils Activate Plasmacytoid Dendritic Cells by Releasing Self-DNA\u2013Peptide Complexes in Systemic Lupus Erythematosus","volume":"3","author":"Lande","year":"2011","journal-title":"Sci. Transl. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13075-015-0521-9","article-title":"Application of the 2012 Systemic Lupus International Collaborating Clinics classification criteria to patients in a regional Swedish systemic lupus erythematosus register","volume":"17","author":"Ighe","year":"2015","journal-title":"Arthritis Res. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/j.berh.2005.03.010","article-title":"Assessment of patients with systemic lupus erythematosus and the use of lupus disease activity indices","volume":"19","author":"Griffiths","year":"2005","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_26","first-page":"1000196","article-title":"Sandwich ELISA for Circulating Myeloperoxidase- and Neutrophil Elastase-DNA Complexes Released from Neutrophil Extracellular Traps","volume":"5","author":"Kano","year":"2016","journal-title":"Adv. Tech. Biol. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1038\/nm.1959","article-title":"Netting neutrophils in autoimmune small-vessel vasculitis","volume":"15","author":"Kessenbrock","year":"2009","journal-title":"Nat. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1111\/apm.13112","article-title":"The Swedish public health response to COVID-19","volume":"129","author":"Tegnell","year":"2021","journal-title":"APMIS"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4172\/2155-9899.1000139","article-title":"Neutrophil Extracellular Traps and Systemic Lupus Erythematosus","volume":"4","author":"Yu","year":"2013","journal-title":"J. Clin. Cell. Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1093\/clinchem\/48.3.421","article-title":"Predominant Hematopoietic Origin of Cell-Free DNA in Plasma and Serum after Sex-Mismatched Bone Marrow Transplantation","volume":"48","author":"Lui","year":"2002","journal-title":"Clin. Chem."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s00430-009-0121-x","article-title":"The clinical value of neutrophil extracellular traps","volume":"198","author":"Margraf","year":"2009","journal-title":"Med. Microbiol. Immunol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Grabuschnig, S., Bronkhorst, A.J., Holdenrieder, S., Rodriguez, I.R., Schliep, K.P., Schwendenwein, D., Ungerer, V., and Sensen, C.W. (2020). Putative Origins of Cell-Free DNA in Humans: A Review of Active and Passive Nucleic Acid Release Mechanisms. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21218062"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"639233","DOI":"10.3389\/fcell.2021.639233","article-title":"Cell-Free DNA: Hope and Potential Application in Cancer","volume":"9","author":"Yan","year":"2021","journal-title":"Front. Cell Dev. Biol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e13015","DOI":"10.1111\/eci.13015","article-title":"High levels of circulating cell-free DNA are a biomarker of active SLE","volume":"48","author":"Xu","year":"2018","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2763","DOI":"10.2169\/internalmedicine.53.2570","article-title":"Elevated Plasma cfDNA May Be Associated with Active Lupus Nephritis and Partially Attributed to Abnormal Regulation of Neutrophil Extracellular Traps (NETs) in Patients with Systemic Lupus Erythematosus","volume":"53","author":"Zhang","year":"2014","journal-title":"Intern. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"103700","DOI":"10.1016\/j.ebiom.2021.103700","article-title":"Relative Ratios of Human Seasonal Coronavirus Antibodies Predict the Efficiency of Cross-Neutralization of SARS-CoV-2 Spike Binding to ACE2","volume":"74","author":"Galipeau","year":"2021","journal-title":"eBioMedicine"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1093\/infdis\/jiab333","article-title":"Detection of Serum Cross-Reactive Antibodies and Memory Response to SARS-CoV-2 in Prepandemic and Post-COVID-19 Convalescent Samples","volume":"224","author":"Shrwani","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1126\/science.abe1107","article-title":"Preexisting and de novo humoral immunity to SARS-CoV-2 in humans","volume":"370","author":"Ng","year":"2020","journal-title":"Science"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Tsukinoki, K., Yamamoto, T., Handa, K., Iwamiya, M., Saruta, J., Ino, S., and Sakurai, T. (2021). Detection of cross-reactive immunoglobulin A against the severe acute respiratory syndrome-coronavirus-2 spike 1 subunit in saliva. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0249979"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Vanroye, F., Bossche, D.V., Brosius, I., Tack, B., Esbroeck, M.V., and Jacobs, J. (2021). COVID-19 Antibody Detecting Rapid Diagnostic Tests Show High Cross-Reactivity When Challenged with Pre-Pandemic Malaria, Schistosomiasis and Dengue Samples. Diagnostics, 11.","DOI":"10.3390\/diagnostics11071163"},{"key":"ref_41","first-page":"304","article-title":"Cross-reaction of SARS-CoV antigen with autoantibodies in autoimmune diseases","volume":"1","author":"Wang","year":"2004","journal-title":"Cell Mol. Immunol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1083\/jcb.201006052","article-title":"Neutrophil elastase and myeloperoxidase regulate the formation of neutrophil extracellular traps","volume":"191","author":"Papayannopoulos","year":"2010","journal-title":"J. Cell Biol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1111\/all.14533","article-title":"Blood myeloperoxidase-DNA, a biomarker of early response to SARS-CoV-2 infection?","volume":"76","author":"Fromonot","year":"2021","journal-title":"Allergy"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1159\/000519869","article-title":"Elevated Myeloperoxidase-DNA Complex Levels in Sera of Patients with IgA Vasculitis","volume":"89","author":"Takeuchi","year":"2022","journal-title":"Pathobiology"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"614829","DOI":"10.3389\/fmed.2021.614829","article-title":"Neutrophil Extracellular Traps in the Autoimmunity Context","volume":"8","author":"Bruschi","year":"2021","journal-title":"Front. Med."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Appelgren, D., Enocsson, H., Skogman, B.H., Nordberg, M., Perander, L., Nyman, D., Nyberg, C., Knopf, J., Mu\u00f1oz, L.E., and Sj\u00f6wall, C. (2019). Neutrophil Extracellular Traps (NETs) in the Cerebrospinal Fluid Samples from Children and Adults with Central Nervous System Infections. Cells, 9.","DOI":"10.3390\/cells9010043"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"377","DOI":"10.3899\/jrheum.181232","article-title":"Neutrophil Extracellular Traps Profiles in Patients with Incident Systemic Lupus Erythematosus and Lupus Nephritis","volume":"47","author":"Bruschi","year":"2020","journal-title":"J. Rheumatol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1038\/nm.4027","article-title":"Neutrophil extracellular traps enriched in oxidized mitochondrial DNA are interferogenic and contribute to lupus-like disease","volume":"22","author":"Lood","year":"2016","journal-title":"Nat. Med."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Hayden, H., Ibrahim, N., Klopf, J., Zagrapan, B., Mauracher, L.-M., Hell, L., Hofbauer, T.M., Ondracek, A.S., Schoergenhofer, C., and Jilma, B. (2021). ELISA detection of MPO-DNA complexes in human plasma is error-prone and yields limited information on neutrophil extracellular traps formed in vivo. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0250265"}],"container-title":["Cells"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2073-4409\/11\/17\/2619\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:13:53Z","timestamp":1760141633000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2073-4409\/11\/17\/2619"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,23]]},"references-count":49,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["cells11172619"],"URL":"https:\/\/doi.org\/10.3390\/cells11172619","relation":{},"ISSN":["2073-4409"],"issn-type":[{"value":"2073-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,23]]}}}