Miftode Radu-Stefan, Petriș Antoniu Octavian, Onofrei Aursulesei Viviana, Cianga Corina, Costache Irina-Iuliana, Mitu Ovidiu, Miftode Ionela-Larisa, Șerban Ionela-Lăcrămioara
Department of Internal Medicine I (Cardiology), Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", 700115 Iasi, Romania.
Department of Immunology, Faculty of Medicine, University of Medicine and Pharmacy "Gr. T. Popa", 700115 Iasi, Romania.
Diagnostics (Basel). 2021 Jan 26;11(2):175. doi: 10.3390/diagnostics11020175.
The increasing incidence of coronavirus disease 19 (COVID-19) and its polymorphic clinical manifestations due to local and systemic inflammation represent a high burden for many public health systems. Multiple evidence revealed the interdependence between the presence of cardiovascular comorbidities and a severe course of COVID-19, with heart failure (HF) being incriminated as an independent predictor of mortality. Suppression of tumorigenicity-2 ST2 has emerged as one of the most promising biomarkers in assessing the evolution and prognosis of patients with HF. The uniqueness of ST2 is determined by its structural particularities. Its transmembrane isoform exerts cardioprotective effects, while the soluble isoform (sST2), which is detectable in serum, is associated with myocardial fibrosis and poor outcome in patients with HF. Some recent data also suggested the potential role of sST2 as a marker of inflammation, while other studies highlighted it as a valuable prognostic factor in patients with COVID-19. In this review, we summarized the pathways by which sST2 is related to myocardial injury and its connection to the severity of inflammation in patients with COVID-19. Also, we reviewed possible perspectives of using it as a dual cardio-inflammatory biomarker, for both early diagnosis, risk stratification and prognosis assessment of patients with concomitant HF and COVID-19.
新型冠状病毒肺炎（COVID-19）发病率不断上升，因其局部和全身炎症导致的临床表现多样，给许多公共卫生系统带来了沉重负担。多项证据表明，心血管合并症与COVID-19的严重病程之间存在相互依存关系，心力衰竭（HF）被认为是死亡率的独立预测因素。抑制致瘤性2 ST2已成为评估HF患者病情演变和预后最有前景的生物标志物之一。ST2的独特性由其结构特殊性决定。其跨膜异构体发挥心脏保护作用，而血清中可检测到的可溶性异构体（sST2）与HF患者的心肌纤维化和不良预后相关。最近的一些数据还表明sST2作为炎症标志物的潜在作用，而其他研究则强调其作为COVID-19患者有价值的预后因素。在本综述中，我们总结了sST2与心肌损伤相关的途径及其与COVID-19患者炎症严重程度的联系。此外，我们还综述了将其用作双重心脏炎症生物标志物的可能前景，用于合并HF和COVID-19患者的早期诊断、风险分层和预后评估。
