Summary

Introduction: Suppression of Tumorigenicity 2 (ST2) plays a key role in all serious complications that may occur during the COVID-19 disease process, such as systemic inflammatory condition, sepsis, acute respiratory distress syndrome (ARDS), and fibrosis. In this study, we evaluated the relationship between serum concentrations of soluble ST2 and mortality and the need for mechanical ventilation.
Materials and Methods: A prospective observational study was conducted from COVID-19 diagnosed patients who presented to the Emergency Department (ED) between October 2021 and April 2022. Patients presenting with SARS-CoV-2 infection were consecutively enrolled in the study of according to the clinical spectrum defined in the guidelines. Admission to the intensive care unit (ICU), requirement of intubation, and mortality within 90 days were the primary outcomes of the study. Clinical, imaging and laboratory data were assessed to clinical spectrum and severity scores. ST2 test works with micro Elisa method and Sandwich-ELISA principle.
Results: Sixty-four (48.5%) patients were hospitalized in the ICU and 43 (32.6%) of these patients required mechanical ventilation. During the 90-day follow-up period, 44 (33.3%) patients died as a result of clinical deterioration. The median value of ST2 at admission was 272,5 ng/ml in patients who died and 55,95 ng/ml in patients who survived (p<0.001). The median value of ST2 at admission was 280 ng/ml in patients who needed mechanical ventilation and 61,1 ng/ml in patients who did not (p<0,001). Area under the receiver operating characteristic curve (AUCs) of soluble ST2 levels for predicting death and need for mechanical ventilation were 0.77 (P <0.001) and 0.79 (P <0.001), respectively.
Conclusion: ST2 measured at the time of admission is a valuable biomarker that can be used in the emergency department because it is more effective than lymphocyte count, d-dimer and ferritin in predicting the need for mechanical ventilation and mortality in COVID-19.