Abstract
ObjectivesWe aim to explore the safety and feasibility of umbilical cord mesenchymal stem cells (UC‐MSCs) transplantation in patients with severe and critically severe coronavirus disease‐2019 (COVID‐19).MethodsWe conducted a small sample, single arm, pilot trial. In addition to standard therapy, we performed four rounds of transplantation of UC‐MSCs in sixteen patients with severe and critically severe COVID‐19. We recorded adverse events from enrolment to Day 28. We evaluated the oxygenation index, inflammatory biomarkers, radiological presentations of the disease and lymphocyte subsets count on the 7th day (D7 ± 1 day), the 14th day (D14 ± 1 day) and the 28th day (D28 ± 3 days).ResultsThere were no infusion‐related or allergic reactions. The oxygenation index was improved after transplantation. The mortality of enrolled patients was 6.25%, whereas the historical mortality rate was 45.4%. The level of cytokines estimated varied in the normal range, the radiological presentations (ground glass opacity) were improved and the lymphocyte count and lymphocyte subsets (CD4+ T cells, CD8+ T cells and NK cells) count showed recovery after transplantation.ConclusionsIntravenous transplantation of UC‐MSCs was safe and feasible for treatment of patients with severe and critically severe COVID‐19 pneumonia.
Highlights
We aim to explore the safety and feasibility of umbilical cord mesenchymal stem cells (UCMSCs) transplantation in severe and critically severe type Coronavirus disease 2019 (COVID-19) patients
Since the first case reported in December 2019 in Wuhan, novel coronavirus disease 2019 (COVID-19) has grown to be a global public health emergency
As the virus can cause a terrible cytokine storm in the lung, such as Interleukin-2 (IL-2), Interleukin-6 (IL-6), Interleukin-7 (IL-7), interferon-induced protein 10 (IP10), monocyte chemoattractant protein 1 (MCP1), macrophage inflammatory protein 1α (MIP1α), and tumor necrosis factor-α (TNF-α), followed by edema, dysfunction of the air exchange, acute respiratory distress syndrome (ARDS), acute cardiac injury, secondary infection, leading to sepsis and multiorgan failure, which may lead to death[1], any treatment that contributes to inhibit the terrible cytokine storm will represent a major step forward
Summary
We aim to explore the safety and feasibility of umbilical cord mesenchymal stem cells (UCMSCs) transplantation in severe and critically severe type Coronavirus disease 2019 (COVID-19) patients. As the virus can cause a terrible cytokine storm in the lung, such as Interleukin-2 (IL-2), Interleukin-6 (IL-6), Interleukin-7 (IL-7), interferon-induced protein 10 (IP10), monocyte chemoattractant protein 1 (MCP1), macrophage inflammatory protein 1α (MIP1α), and tumor necrosis factor-α (TNF-α), followed by edema, dysfunction of the air exchange, acute respiratory distress syndrome (ARDS), acute cardiac injury, secondary infection, leading to sepsis and multiorgan failure, which may lead to death[1], any treatment that contributes to inhibit the terrible cytokine storm will represent a major step forward Under this situation, stem cell therapy has become a promising therapeutic strategy due to their potential of self-renewal, multidirectional differentiation, anti-inflammatory and immune regulatory functions. MSCs can secrete many types of cytokines by paracrine secretion or make direct interactions with immune cells leading to immunomodulation
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