Abstract
The severe respiratory consequences of the coronavirus disease 2019 (COVID-19) pandemic have prompted the urgent need for novel therapies. Cell-based therapies, primarily using mesenchymal stromal cells (MSCs), have demonstrated safety and potential efficacy in the treatment of critical illness, particularly sepsis and acute respiratory distress syndrome (ARDS). However, there are limited preclinical data for MSCs in COVID-19. Recent studies have shown that MSCs could decrease inflammation, improve lung permeability, enhance microbe and alveolar fluid clearance, and promote lung epithelial and endothelial repair. In addition, MSC-based therapy has shown promising effects in preclinical studies and phase 1 clinical trials in sepsis and ARDS. Here, we review recent advances related to MSC-based therapy in the context of sepsis and ARDS and evaluate the potential value of MSCs as a therapeutic strategy for COVID-19.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly and continuously spreading globally and can result in serious significant respiratory morbidity and mortality [1, 2]
After 1 month of follow-up, it was observed that the mortality between the two groups was significantly different (7.69% in the mesenchymal stromal cells (MSCs) group vs. 33.33% in the control group, p = 0.048)
The results reflected that umbilical cord MSCs (UC-MSCs) treatment resulted in significant reductions of inflammatory cytokines on day 6 and improved survival (91% vs. 42%, p = 0.015) during a 31-day follow-up
Summary
The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly and continuously spreading globally and can result in serious significant respiratory morbidity and mortality [1, 2]. A growing number of studies have suggested that MSCs may be a potential therapy for ARDS by improving lung permeability, increasing alveolar fluid clearance, and promoting lung epithelial and endothelial repair. The results reflected that UC-MSC treatment resulted in significant reductions of inflammatory cytokines on day 6 and improved survival (91% vs 42%, p = 0.015) during a 31-day follow-up In another double-blind, multicenter, phase 1 randomized controlled trial (NCT04457609) [130] in 40 critically ill COVID-19 patients, 20 patients received a single intravenous infusion of 1 × 106/kg UC-MSCs in 100 ml saline (0.9%) solution (SS) and 20 patients received 100 ml 0.9% SS as the control group. Further highquality randomized clinical trials are needed to provide evidence
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