入院时可溶性抑制肿瘤生成标志物 2（sST2）升高对 COVID-19 患者严重程度的指示价值。

Value of increased soluble suppressor tumorigenicity biomarker 2 (sST2) on admission as an indicator of severity in patients with COVID-19.

机构信息

Clinical Laboratory Service, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain; Universidad de Murcia, Murcia, Spain.

Clinical Laboratory Service, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain; Universidad de Murcia, Murcia, Spain; IMIB Pascual Parrilla, Murcia, Spain.

出版信息

Med Clin (Barc). 2023 Sep 8;161(5):185-191. doi: 10.1016/j.medcli.2023.04.005. Epub 2023 Apr 11.

DOI:10.1016/j.medcli.2023.04.005

PMID:37137804

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10086099/

Abstract

BACKGROUND

Soluble suppressor of tumorigenicity-2 (sST2) is a biomarker for heart failure and pulmonary injury. We hypothesize that sST2 could help predict severity of SARS-CoV-2 infections.

METHODS

sST2 was analyzed in patients consecutively admitted for SARS-CoV-2 pneumonia. Other prognostic markers were also measured. In-hospital complications were registered, including death, ICU admission, and respiratory support requirements.

RESULTS

495 patients were studied (53% male, age: 57.6±17.6). At admission, median sST2 concentrations was 48.5ng/mL [IQR, 30.6-83.1ng/mL] and correlated with male gender, older age, comorbidities, other severity biomarkers, and respiratory support requirements. sST2 levels were higher in patients who died (n=45, 9.1%) (45.6 [28.0, 75.9]ng/mL vs. 144 [82.6, 319] ng/mL, p<0.001) and those admitted to ICU (n=46, 9.3%) (44.7 [27.5, 71.3] ng/mL vs. 125 [69.0, 262]ng/mL, p<0.001). sST2 levels>210ng/mL were a strong predictor of complicated in-hospital courses, with higher risk of death (OR, 39.3, CI95% 15.9, 103) and death/ICU (OR 38.3, CI95% 16.3-97.5) after adjusting for all other risk factors. The addition of sST2 enhanced the predictive capacity of mortality risk models.

CONCLUSIONS

sST2 represents a robust severity predictor in COVID-19 and could be an important tool for identifying at-risk patients who may benefit from closer follow-up and specific therapies.

摘要

背景

可溶性肿瘤抑制因子 2（sST2）是心力衰竭和肺损伤的生物标志物。我们假设 sST2 可帮助预测严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的严重程度。

方法

对连续因 SARS-CoV-2 肺炎入院的患者进行 sST2 分析。还测量了其他预后标志物。登记了院内并发症，包括死亡、入住重症监护病房（ICU）和呼吸支持需求。

结果

共研究了 495 例患者（53%为男性，年龄：57.6±17.6 岁）。入院时，中位 sST2 浓度为 48.5ng/mL [IQR，30.6-83.1ng/mL]，与男性、年龄较大、合并症、其他严重程度生物标志物和呼吸支持需求相关。死亡患者（n=45，9.1%）（45.6 [28.0，75.9]ng/mL 比 144 [82.6，319]ng/mL，p<0.001）和入住 ICU 患者（n=46，9.3%）（44.7 [27.5，71.3]ng/mL 比 125 [69.0，262]ng/mL，p<0.001）的 sST2 水平更高。sST2 水平>210ng/mL 是院内并发症复杂的强烈预测指标，死亡风险（OR，39.3，95%CI15.9，103）和死亡/入住 ICU（OR，38.3，95%CI16.3-97.5）的风险均更高，在调整了所有其他危险因素后。sST2 的加入增强了死亡率风险模型的预测能力。