Chunlian Lai,1,* Yingfei Wang,2– 4,* Fengwei Shi,2– 4,* Nan Geng,1 Zhao Liu,1 Wen Pan,1 Hongbo Shi,3,5 Yingmin Ma,2– 4 Bo Liu1 

1Department of Emergency Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 3Beijing Institute of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 4Beijing Research Center for Respiratory Infectious Diseases, Beijing, 100013, People’s Republic of China; 5Beijing Engineering Research Center for Precision Medicine and Transformation of Hepatitis and Liver Cancer, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yingmin Ma, Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, No. 8, Xi Tou Tiao, Youanmenwai Street, Fengtai District, Beijing City, 100069, People’s Republic of China, Email ma.yingmin@163.com Bo Liu, Department of Emergency Medicine, Beijing Youan Hospital, Capital Medical University, No. 8, Xi Tou Tiao, Youanmenwai Street, Fengtai District, Beijing City, 100069, People’s Republic of China, Email Rippleyayy@sina.com

Background: Coronavirus Disease 2019 (COVID-19), caused by the novel coronavirus, has posed a significant threat to global public health, leading to substantial morbidity, mortality, and strain on healthcare resources. Despite the availability of vaccines and treatments, effective biomarkers for predicting disease progression remain limited. This study aimed to investigate the prognostic value of soluble fms-like tyrosine kinase-1 (sFlt-1) in COVID-19 patients.
Methods: A prospective cohort study was conducted involving 154 COVID-19 patients, with comprehensive clinical data and laboratory parameters analyzed to evaluate the effectiveness of sFlt-1 in determining disease severity and prognosis.
Results: The results revealed that sFlt-1 levels correlated significantly with disease severity, showing higher levels in severe/critical cases compared to mild cases (P< 0.05). In the deceased group, sFlt-1 levels were notably higher compared to survivors, with an area under the curve (AUC) of 0.840, showing good predictive power for 28-day mortality. Multivariable logistic regression identified sFlt-1, respiratory rate, and albumin as independent prognostic factors, with a combined AUC of 0.938 (95% CI: 0.886– 0.991) for predicting mortality risk.
Conclusion: These findings underscore the potential of sFlt-1 as a valuable biomarker for clinical decision-making in managing COVID-19 patients. Future studies should focus on the clinical application of sFlt-1 and explore its underlying mechanisms to enhance patient management strategies.

Keywords: COVID-19, sFlt-1, 28-day mortality, disease severity