Yan Yongcui, Zhuang Yan, Li Huihui, Wang Dao Wen
Division 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.
J Cardiovasc Dev Dis. 2025 Jul 17;12(7):273. doi: 10.3390/jcdd12070273.
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.
This retrospective cohort study included 314 hospitalized COVID-19 patients classified into mild/moderate ( = 168) and severe/critical ( = 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.
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).
Elevated sST2 is associated with myocardial injury, inflammation, and poor prognosis in COVID-19, supporting its value for risk stratification.
2019冠状病毒病（COVID-19）常伴有心血管系统受累。可溶性生长刺激表达基因2（sST2）是一种很有前景的心血管生物标志物，但其在COVID-19中的预后价值仍不明确。
这项回顾性队列研究纳入了314例住院的COVID-19患者，分为轻/中症组（n = 168）和重症/危重症组（n = 146）。采用酶联免疫吸附测定法检测血浆sST2水平。相关性分析评估sST2与临床参数之间的关联。Cox回归分析评估心血管事件和全因死亡率的独立预测价值。
重症/危重症患者的sST2水平（16.877 ng/mL）显著高于轻/中症患者（6.189 ng/mL）和健康对照者（4.003 ng/mL）。sST2与心脏损伤标志物（肌钙蛋白I、肌酸激酶同工酶、N末端脑钠肽前体）、炎症指标（白细胞介素-1β、高敏C反应蛋白）、D-二聚体呈正相关，与左心室射血分数呈负相关（r = -0.86）。sST2升高独立预测心血管事件（风险比=2.972）和死亡率（风险比=4.681）。Kaplan-Meier生存分析显示，sST2升高的患者心血管事件发生率更高，生存概率更低。ROC曲线表明sST2在预测心血管事件（曲线下面积=0.898）和死亡率（曲线下面积=0.871）方面优于肌钙蛋白I和N末端脑钠肽前体。
sST2升高与COVID-19患者的心肌损伤、炎症及不良预后相关，支持其在风险分层中的价值。
