Abstract
Objective: To evaluate mesenchymal stem cell (MSC) administration safety and efficacy in COVID-19 patients. Methods: We conducted a literature search on PubMed/MEDLINE, medRxiv, EBSCOhost/CINAHL, ProQuest, and Scopus with keywords adjusted to each search engine’s specifications on February 12, 2021. Interventional studies that reviewed MSC efficacy (mortality, hospitalization duration, need for mechanical ventilators, and inflammation markers) and/or safety (adverse events) in COVID-19 patients who were 18 years old or more were included in this study. Study eligibility, data extraction, and study quality assessment were conducted independently by each author. Results: A total of five studies of moderate to high quality with a total of 193 patients were included. One of the three randomized studies included did not apply blinding to either participants or medical professionals. Pooled OR (Odd Ratio) for mortality risk, adverse events incidence, and use of mechanical ventilators for patients on MSC therapy were 0.13 [95% CI: 0.02, 0.68], 0.91 [95% CI: 0.45, 1.86], and 0.42 [95% CI: 0.12, 1.47], respectively. Pooled mean difference for hospitalization duration in the MSC group versus the control was -3.54 [CI 95%: -4.68, -2.40] with 7% heterogeneity. All studies agreed that there was an increase of pro-inflammatory cytokines and a decrease of anti-inflammatory markers that were statistically different in the MSC group. Conclusion: Mesenchymal stem cell administration to COVID-19 patients is safe and effective in reducing mortality and hospitalization duration. Furthermore, a decrease of pro-inflammatory cytokines and an increase in anti-inflammatory cytokines were observed.
Highlights
Coronavirus disease 2019 (COVID-19) is a new disease that resembles pneumonia
Cough, and shortness of breath that are typical of pneumonia, COVID-19 has various clinical manifestations ranging from sore throat, fatigue, dizziness, myalgia, chest pain, rhinitis, neurological manifestations, conjunctivitis, anorexia, diarrhea, skin manifestations such as rashes and urticaria, and some are even asymptomatic.[3,4,5]
In this study, pooled OR for the mesenchymal stem cell (MSC) group that required a mechanical ventilator during treatment was 0.42 [95% CI: 0.12, 1.47]
Summary
Coronavirus disease 2019 (COVID-19) is a new disease that resembles pneumonia. As of August 2021, more than 200 million people worldwide have been infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the virus that causes COVID-19, and more than four million people have died.[1]. Even though it has a mortality rate that is not too high (case fatality rate of 2-3%), deaths from COVID-19 should not be underestimated.[3] Various types of treatment for COVID-19 have been observed in trials such as various antivirals, dexamethasone, anti-inflammatory drugs, and even convalescent plasma therapy. Most of these treatments have not proved effective and only the drug, remdesivir, has been shown to be effective and approved by the FDA (US Food and Drug Administration). These controversial findings prompted the authors to conduct a systematic review and meta-analysis of MSC safety and efficacy in COVID-19 patients
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