A possible role for ST2 as prognostic biomarker for COVID-19

Ragusa, Rosetta; Basta, Giuseppina; Turco, Serena Del; Caselli, C.

doi:10.1016/j.vph.2021.106857

Cited by 23 publications

(15 citation statements)

References 94 publications

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“…The IL-33/ST2 axis might play a leading role in COVID-19 pathogenesis [32][33][34][35]. Although our study was not aimed to gain pathophysiological insight into COVID-19, our findings support this hypothesis.…”

Section: Discussionsupporting

confidence: 71%

“…sST2 has been shown to be elevated in patients with Kawasaki disease which, in addition, correlated with clinical worse course [40,41]. More importantly, cardiovascular co-morbidity, and more specifically HF, has been identified as a significant risk factor for COVID-19 severity and worse outcome [34,35,42]. sST2 is also an established prognosis maker in HF.…”

Section: Discussionmentioning

confidence: 99%

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Early Measurement of Blood sST2 Is a Good Predictor of Death and Poor Outcomes in Patients Admitted for COVID-19 Infection

Sánchez‐Marteles

Rubio-Gracia

Peña-Fresneda

et al. 2021

JCM

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Although several biomarkers have shown correlation to prognosis in COVID-19 patients, their clinical value is limited because of lack of specificity, suboptimal sensibility or poor dynamic behavior. We hypothesized that circulating soluble ST2 (sST2) could be associated to a worse outcome in COVID-19. In total, 152 patients admitted for confirmed COVID-19 were included in a prospective non-interventional, observational study. Blood samples were drawn at admission, 48–72 h later and at discharge. sST2 concentrations and routine blood laboratory were analyzed. Primary endpoints were admission at intensive care unit (ICU) and mortality. Median age was 57.5 years [Standard Deviation (SD: 12.8)], 60.4% males. 10% of patients (n = 15) were derived to ICU and/or died during admission. Median (IQR) sST2 serum concentration (ng/mL) rose to 53.1 (30.9) at admission, peaked at 48–72 h (79.5(64)) and returned to admission levels at discharge (44.9[36.7]). A concentration of sST2 above 58.9 ng/mL was identified patients progressing to ICU admission or death. Results remained significant after multivariable analysis. The area under the receiver operating characteristics curve (AUC) of sST2 for endpoints was 0.776 (p = 0.001). In patients admitted for COVID-19 infection, early measurement of sST2 was able to identify patients at risk of severe complications or death.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Early Measurement of Blood sST2 Is a Good Predictor of Death and Poor Outcomes in Patients Admitted for COVID-19 Infection

Sánchez‐Marteles

Rubio-Gracia

Peña-Fresneda

et al. 2021

JCM

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“…We found high concentrations of ST2 in the plasma of COVID-19 patients, which has been suggested to be related to endothelial or pneumocyte inflammation and damage [11]. We found that higher levels of ST2 were associated with mortality, which supports the prognostic value of this biomarker in COVID-19, as suggested elsewhere [22].…”

Section: Discussionsupporting

confidence: 87%

Plasma biomarkers associated with survival and thrombosis in hospitalized COVID-19 patients

Cabrera-Garcia

Miltiades

Yim

et al. 2021

Preprint

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Severe coronavirus disease-19 (COVID-19) has been associated with fibrin-mediated hypercoagulability and thromboembolic complications. To evaluate potential biomarkers of coagulopathy and disease severity in COVID-19, we measured plasma levels of eight biomarkers potentially associated with coagulation, fibrinolysis, and platelet function in 43 controls and 63 COVID-19 patients, including 47 patients admitted to the intensive care unit (ICU) and 16 non-ICU patients. COVID-19 patients showed significantly elevated levels of fibrinogen, tissue plasminogen activator (t-PA), and its inhibitor plasminogen activation inhibitor 1 (PAI-1), as well as ST2 (the receptor for interleukin 33) and von Willebrand factor (vWF) compared to the control group. We found that higher levels of t-PA, ST2, and vWF at the time of admission were associated with lower survival rates, and that thrombotic events were more frequent in patients with initial higher levels of vWF. These results support a predictive role of specific biomarkers such as t-PA and vWF in the pathophysiology of COVID-19. The data provide support for the case that hypercoagulability in COVID-19 is fibrin-mediated, but also highlights the important role that vWF may play in the genesis of thromboses in the pathophysiology of COVID-19. Interventions designed to enhance fibrinolysis and reduce platelet aggregation might prove to be useful adjuncts in the treatment of coagulopathy in a subset of COVID-19 patients.

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“…This gene has been known to be cardioprotective for myocardial functions and has been implicated with increased cardiomyocyte hypertrophy and ventricular fibrosis upon germline deletion of ST2 in mouse models. Furthermore, ST2 57 has also been tolled as a promising prognostic biomarker for COVID-19 58 with ST2 serum level suggested to be significantly increased in COVID-19 patients 59 , as opposed to the significant downregulation of IL1RL1 in COVID-19 heart samples .…”

Section: Resultsmentioning

confidence: 99%

Transcriptomic profiling of cardiac tissues from SARS-CoV-2 patients identifies DNA damage

Kulasinghe

Liu

Tan

et al. 2022

Preprint

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is known to present with pulmonary and extra-pulmonary organ complications. In comparison with the 2009 pandemic (pH1N1), SARS-CoV-2 infection is likely to lead to more severe disease, with multi-organ effects, including cardiovascular disease. SARS-CoV-2 has been associated with acute and long-term cardiovascular disease, but the molecular changes govern this remain unknown. In this study, we investigated the landscape of cardiac tissues collected at rapid autopsy from SARS-CoV-2, pH1N1, and control patients using targeted spatial transcriptomics approaches. Although SARS-CoV-2 was not detected in cardiac tissue, host transcriptomics showed upregulation of genes associated with DNA damage and repair, heat shock, and M1-like macrophage infiltration in the cardiac tissues of COVID-19 patients. The DNA damage present in the SARS-CoV-2 patient samples, were further confirmed by gamma-H2Ax immunohistochemistry. In comparison, pH1N1 showed upregulation of Interferon-stimulated genes (ISGs), in particular interferon and complement pathways, when compared with COVID-19 patients. These data demonstrate the emergence of distinct transcriptomic profiles in cardiac tissues of SARS-CoV-2 and pH1N1 influenza infection supporting the need for a greater understanding of the effects on extra-pulmonary organs, including the cardiovascular system of COVID-19 patients, to delineate the immunopathobiology of SARS-CoV-2 infection, and long term impact on health.

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A possible role for ST2 as prognostic biomarker for COVID-19

Cited by 23 publications

References 94 publications

Early Measurement of Blood sST2 Is a Good Predictor of Death and Poor Outcomes in Patients Admitted for COVID-19 Infection

Early Measurement of Blood sST2 Is a Good Predictor of Death and Poor Outcomes in Patients Admitted for COVID-19 Infection

Plasma biomarkers associated with survival and thrombosis in hospitalized COVID-19 patients

Transcriptomic profiling of cardiac tissues from SARS-CoV-2 patients identifies DNA damage

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