Objective:

To identify transcriptomic markers of NETosis associated with poor outcomes in neonatal sepsis and investigate their relationship with coagulation, emphasizing the clinical significance of this relationship.

Key Findings:

• The NET score is a strong predictor of adverse outcomes in neonatal sepsis, indicating its potential as a clinical tool.
• A sequential relationship exists between NETosis and coagulation in sepsis, suggesting a pathway for targeted interventions.
• Neonates with disseminated intravascular coagulation showed elevated NET scores, highlighting the need for monitoring in this population.

Interpretation:

The NET score may serve as a novel risk stratification tool to identify neonates at increased risk for sepsis-associated coagulopathy and poor outcomes, potentially guiding targeted therapies and improving clinical decision-making.

Limitations:

• Patient heterogeneity may affect the generalizability of findings, particularly in diverse clinical settings.
• The study is based on transcriptomic data, which may not fully capture protein-level changes, potentially limiting the applicability of findings.

Conclusion:

The findings support the use of NET-specific biomarkers for improving prognostic accuracy and guiding treatment strategies in neonatal sepsis, with the potential to enhance patient outcomes.