Abstract: Objective To explore the predictive value of soluble growth stimulation expressed gene 2 protein (sST2) in the prognosis of end-stage renal disease (ESRD) patients with corona virus disease 2019 (COVID-19). Methods Retrospective analysis was conducted on the clinical data of ESRD patients with COVID-19. Univariate and multivariate logistic regression analyses were performed to investigate the risk factors for disease severity and mortality in ESRD patients with COVID-19. The predictive value of cytokines for patient prognosis was analyzed. Results A total of 100 ESRD patients with COVID-19 were included, including 60 mild cases, 22 severe cases, and 18 critically ill cases. Multivariate logistic regression showed that blood oxygen saturation upon admission, albumin levels, coronary heart disease, and continuous renal replacement therapy were independent risk factors for severe and critical COVID-19 in ESRD patients. Coronary heart disease, albumin levels, lactate dehydrogenase, and mechanical ventilation were independent risk factors for patient mortality. The area under the ROC curve (AUC) for sST2 in predicting severe and critical COVID-19 in ESRD patients at admission was 0.706 (95% CI: 0.563-0.848, P=0.009), and the AUC for predicting mortality was 0.837 (95% CI: 0.729-0.944, P=0.007). The model combining IL-6 and sST2 for predicting mortality had an AUC of 0.923 (95% CI: 0.850-0.996, P=0.001). Conclusions sST2 can be used as a biological marker to predict the prognosis of ESRD patients with COVID-19.