Abstract
In 2020, we suggested that umbilical cord-derived mesenchymal stem cell (UC-MSC) transplantation can significantly improve COVID-19 symptoms based on evidential relations (10.4252/wjsc.v12.i8.721). One year later, this review aims to summarize and update the clinical evidence regarding UC-MSC usage in COVID-19 treatment. The publications on applications of UC-MSCs were searched in the PubMed, Web of Science, and Google scholar databases with the keywords “umbilical cord-derived mesenchymal stem cells” and “COVID-19”. All publications about clinical studies, from case reports to randomized controlled trials (RCTs), were used as clinical evidence in this review. The results showed 16 publications (4 randomized clinical trials, 3 pilot studies/phase 1 clinical trials, 3 case series reports, and 6 case reports) with a total of 395 COVID-19 patients that were provided with UC-MSC transplantation. All publications demonstrated that UC-MSC transplantation is safe, well tolerated, improved COVID-19 symptoms, and significantly decreased mortality. These findings support our suggestion for the usage of off-the-shelf UC-MSCs for COVID-19 as an adjuvant therapy.
Highlights
Based on early evidence of the usage of mesenchymal stem cells (MSCs) in COVID-19 treatment 11 and from published clinical usages of umbilical cord-derived mesenchymal stem cell (UC-MSC) in chronic obstructive pulmonary disease (COPD) 20 and septic illnesses [21,22,23], we have suggested the usage of off-theshelf UC-MSC products for COVID-19 14
This review aims to outline the opinions based on pooled published clinical evidence regarding UC-MSC transplantation in COVID-19 patients
Hashemian et al (2021) followed-up 12 patients with UC-MSC transplantation for 60 days and found no allergic reactions or serious adverse events (SAEs) during this time 38. These results suggested that UC-MSC transplantation in COVID-19 patients is safe, and without severe side effects
Summary
Coronavirus disease 2019 (COVID-19) is a new pandemic that has affected hundreds of millions of people worldwide. COVID-19 patients with comorbidities tend to be more affected by this disease and have a higher mortality rate [2,3,4] than children and young people. Many therapies are being developed to effectively treat and manage COVID-19, one of which is stem cell therapy. Based on the pathophysiology of COVID-19 and biological characteristics of mesenchymal stem cells (MSCs), these cells have been used at an early clinical stage in some clinical trials to treat severe and critical COVID-19 patients 11. MSCs are the most frequently isolated adult stem cells from various tissues in the body. MSCs can participate in disease treatment and management through at least three mechanisms: immune modulation, multilineage differentiation, and regeneration triggering through their cytokines 14.
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