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Plasma Soluble ST2 as a Prognostic Biomarker for Cardiovascular Events and Mortality in COVID-19 Patients
Yongcui Yan1, Yan Zhuang1, Huihui Li1
1Division of Cardiology and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Insights
Elevated soluble growth stimulation-expressed gene 2 (sST2) indicates higher risk of cardiovascular events and mortality in COVID-19 patients. This biomarker aids in identifying severe cases and predicting poor outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Biomarker Research
Background:
- COVID-19 frequently causes cardiovascular complications.
- Soluble growth stimulation-expressed gene 2 (sST2) is a potential cardiovascular biomarker.
- The prognostic significance of sST2 in COVID-19 patients is not well-established.
Purpose of the Study:
- To investigate the prognostic value of sST2 in hospitalized COVID-19 patients.
- To assess the association between sST2 levels and cardiovascular events and mortality.
- To evaluate sST2's predictive performance compared to other biomarkers.
Main Methods:
- Retrospective cohort study of 314 hospitalized COVID-19 patients (mild/moderate vs. severe/critical).
- Plasma sST2 levels measured via ELISA.
- Correlation analyses and Cox regression used to assess associations and predictive value.
Main Results:
- Severe/critical COVID-19 patients exhibited significantly higher sST2 levels than mild/moderate cases and controls.
- Elevated sST2 correlated with cardiac injury markers, inflammation, and D-dimer, and inversely with left ventricular ejection fraction.
- sST2 independently predicted cardiovascular events and all-cause mortality, outperforming cTnI and NT-proBNP.
Conclusions:
- Elevated sST2 is linked to myocardial injury, inflammation, and adverse outcomes in COVID-19.
- sST2 demonstrates significant prognostic value for risk stratification in COVID-19 patients.
- sST2 is a promising biomarker for predicting cardiovascular events and mortality in COVID-19.
Background:
Coronavirus disease 2019 (COVID-19) is frequently complicated by cardiovascular involvement. Soluble growth stimulation-expressed gene 2 (sST2) is a promising cardiovascular biomarker, but its prognostic value in COVID-19 remains unclear.
Methods:
This retrospective cohort study included 314 hospitalized COVID-19 patients classified into mild/moderate (n = 168) and severe/critical (n = 146). Plasma sST2 were measured using an enzyme-linked immunosorbent assay. Correlation analyses evaluated associations between sST2 and clinical parameters. Cox regression assessed the independent predictive value for cardiovascular events and all-cause mortality.
Results:
sST2 levels were significantly higher in severe/critical patients (16.877 ng/mL) than in mild/moderate cases (6.189 ng/mL) and healthy controls (4.003 ng/mL). sST2 positively correlated with cardiac injury markers (cTnI, CK-Mb, NT-proBNP), inflammatory indices (IL-1β, hsCRP), D-dimer, and inversely correlated with a left ventricular ejection fraction (r = -0.86). Elevated sST2 independently predicted cardiovascular events (HR = 2.972) and mortality (HR = 4.681). The Kaplan-Meier survival analysis demonstrated higher cardiovascular event rates and lower survival probabilities in patients with elevated sST2. The ROC curve indicated sST2 outperformed cTnI and NT-proBNP in predicting cardiovascular events (AUC = 0.898) and mortality (AUC = 0.871).
Conclusion:
Elevated sST2 is associated with myocardial injury, inflammation, and poor prognosis in COVID-19, supporting its value for risk stratification.
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