Plasma Soluble ST2 as a Prognostic Biomarker for Cardiovascular Events and Mortality in COVID-19 Patients

Figures

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  Figure 1. COVID-19 patient enrollment and selection flowchart.

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  Figure 2. Plasma soluble ST2 (sST2) concentrations in mild/moderate and severe/critical COVID-19 patients. Plasma sST2 levels in patients with severe/critical COVID-19 (n = 146), mild/moderate COVID-19 (n = 168), and healthy controls (n = 213) were measured by ELISA. Data are presented as medians with interquartile ranges [Q1–Q3]; Kruskal–Wallis test was used to elevate the differences, *** p < 0.001.

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  Figure 3. Correlation matrix of plasma sST2 and other clinical biomarkers in hospitalized COVID-19 patients. Spearman correlation analysis of plasma sST2 concentrations with a panel of cardiac injury biomarkers (cTnI, CK-Mb, Mb, and NT-proBNP), inflammatory cytokines (IL-10, IL-1β, IL-2R, IL-4, and hsCRP), and biochemical parameters (ALT, AST, creatinine, LDH, and D-dimer), as well as the left ventricular ejection fraction (LVEF). The color scale represents the strength and direction of correlations, with red indicating positive and blue indicating negative associations. The intensity of the color corresponds to the magnitude of the correlation coefficient (r). * p < 0.05, ** p < 0.01, and *** p < 0.001.

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  Figure 4. Kaplan–Meier analysis of cardiovascular events and all-cause mortality stratified by plasma sST2 levels in hospitalized COVID-19 patients. Patients were stratified into high and low sST2 groups based on the median plasma sST2 concentration at admission. Kaplan–Meier curve for the cumulative incidence of cardiovascular events (A) and all-cause mortality (B) in hospitalized COVID-19 patients. Shaded areas represent 95% confidence intervals.

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  Figure 5. Receiver operating characteristic (ROC) curve analysis of sST2 and conventional biomarkers for predicting cardiovascular events and all-cause mortality in COVID-19 patients. Receiver operating characteristic (ROC) curves of plasma sST2, cTnI, NT-proBNP, IL-1β, and IL-2R for cardiovascular events (A) and all-cause mortality (B). AUC values for each biomarker are presented in the legend within each panel.