Mesenchymal stem cells in the treatment of coronavirus-induced pneumonia (COVID-19)

Mazzeo, Angela; Santos, Enrico Jardim Clemente

doi:10.31744/einstein_journal/2020ce5802

Cited by 9 publications

(7 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The MSC-based therapy protocols to treat COVID-19 have been directed mainly to patients with moderate and severe clinical presentations (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Few studies included critically ill patients with COVID-19 under invasive mechanical ventilation (26)(27)(28).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Immunomodulatory and Anti-fibrotic Effects Following the Infusion of Umbilical Cord Mesenchymal Stromal Cells in a Critically Ill Patient With COVID-19 Presenting Lung Fibrosis: A Case Report

et al. 2021

View full text Add to dashboard Cite

Background: The patients with coronavirus disease 2019 (COVID-19) associated with severe acute respiratory distress syndrome (ARDS) may require prolonged mechanical ventilation which often results in lung fibrosis, thus worsening the prognosis and increasing fatality rates. A mesenchymal stromal cell (MSC) therapy may decrease lung inflammation and accelerate recovery in COVID-19. In this context, some studies have reported the effects of MSC therapy for patients not requiring invasive ventilation or during the first hours of tracheal intubation. However, this is the first case report presenting the reduction of not only lung inflammation but also lung fibrosis in a critically ill long-term mechanically ventilated patient with COVID-19.Case Presentation: This is a case report of a 30-year-old male patient with COVID-19 under invasive mechanical ventilation for 14 days in the intensive care unit (ICU), who presented progressive clinical deterioration associated with lung fibrosis. The symptoms onset was 35 days before MSC therapy. The patient was treated with allogenic human umbilical-cord derived MSCs [5 × 107 (2 doses 2 days interval)]. No serious adverse events were observed during and after MSC administration. After MSC therapy, PaO2/FiO2 ratio increased, the need for vasoactive drugs reduced, chest CT scan imaging, which initially showed signs of bilateral and peripheral ground-glass, as well as consolidation and fibrosis, improved, and the systemic mediators associated with inflammation decreased. Modulation of the different cell populations in peripheral blood was also observed, such as a reduction in inflammatory monocytes and an increase in the frequency of patrolling monocytes, CD4+ lymphocytes, and type 2 classical dendritic cells (cDC2). The patient was discharged 13 days after the cell therapy.Conclusions: Mesenchymal stromal cell therapy may be a promising option in critically ill patients with COVID-19 presenting both severe lung inflammation and fibrosis. Further clinical trials could better assess the efficacy of MSC therapy in critically ill patients with COVID-19 with lung fibrosis associated with long-term mechanical ventilation.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The mesenchymal stromal cells (MSCs) have been evaluated in compassionate use or clinical trials to treat COVID-19 pneumonia (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). The rationale of this therapy is to direct the immunomodulatory properties of the MSCs to control the hyperinflammatory state and improve respiratory function (20).…”

mentioning

confidence: 99%

Immunomodulatory and Anti-fibrotic Effects Following the Infusion of Umbilical Cord Mesenchymal Stromal Cells in a Critically Ill Patient With COVID-19 Presenting Lung Fibrosis: A Case Report

et al. 2021

View full text Add to dashboard Cite

show abstract

“…MSC-based therapy protocols to treat COVID-19 have been directed mainly to patients with moderate and severe clinical presentations [9][10][11][12][13][14][15][16][17][18]. Few numbers of studies included critically ill patients with COVID-19 under invasive mechanical ventilation [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

“…Mesenchymal stromal cells (MSCs) have been evaluated in compassionate use or clinical trials to treat COVID-19 pneumonia [9][10][11][12][13][14][15][16][17][18]. The rationale is to direct the immunomodulatory properties of MSCs to control the hyperin ammatory state and improve respiratory function.…”

mentioning

confidence: 99%

Intravenous Administration of Umbilical Cord Mesenchymal Stromal Cells in Advanced-stage Critical COVID-19: a Case Report

Silva

Pinheiro

Gobatto

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Coronavirus disease 2019 (COVID-19) associated- severe acute respiratory distress syndrome (ARDS) patients may require prolonged mechanical ventilation, thus resulting in lung fibrosis and high fatality rates. Several therapies have been developed in patients with pneumonia requiring oxygen therapy as well as during the early course of invasive mechanical ventilation. Mesenchymal stromal cells (MSCs) may have a role in controlling the hyperinflammatory response seen in such cases and prevent aggravation or increase/accelerate recovery. While MSC-based therapies have been studied mostly in patients that did not require invasive ventilation or during the first hours of tracheal intubation, to date the potential of MSC therapy to treat advanced-stage of severe/critical COVID-19 cases has not been extensively studied. Methods: This is a case report of a 30-year-old male patient who presented progressive clinical deterioration of COVID-19 in ICU after 21-day admission and 14 days with invasive mechanical ventilation. The first symptom onset was 35 days before MSC therapy. The patient was treated with allogenic human umbilical cord-derived MSCs [5 x 107 (2 doses 2 days interval)].Results: No serious adverse events attributed to MSC administration were observed during and after the procedure. Oxygenation (PaO2/FiO2 ratio) and the need for vasoactive drugs improved. Chest CT scan imaging, which showed signs of bilateral and peripheral ground-glass, consolidation as well as fibrosis, improved significantly during the time course of the disease. Patient was discharged 13 days after cell therapy. Cytokine analysis demonstrated modulation of different mediators accompanied by modulation of different cell populations in peripheral blood, including a reduction in inflammatory monocytes, increased frequency of patrolling monocytes, CD4+ lymphocytes and type 2 classical dendritic cells (cDC2). Conclusion: This study described for the first time the effects of MSC therapy in a patient at late stage COVID-19 associated severe lung injury and fibrosis. Therefore, further clinical trials should be design assessing the efficacy of MSC therapy in ARDS patients undergoing prolonged mechanical ventilation due to COVID-19.

show abstract

“…Clinical experience with cell-based therapies for COVID-19 remains limited. Although multiple clinical trials are registered in public databases, such as clinicaltrials.gov (Table 1), only preliminary results from a few clinical studies have been published (Table 2) [66,130,[139][140][141][142][143][144][145][146][147][148][149][150][151][152][153][154]. Many translational gaps have led to a tremendous variety in protocols, cell sources, and dosage regimens; there is also great heterogeneity in clinical presentations and stages of the disease.…”

Section: Covid-19mentioning

confidence: 99%

Is there a place for mesenchymal stromal cell-based therapies in the therapeutic armamentarium against COVID-19?

et al. 2021

View full text Add to dashboard Cite

The COVID-19 pandemic, caused by the rapid global spread of the novel coronavirus (SARS-CoV-2), has caused healthcare systems to collapse and led to hundreds of thousands of deaths. The clinical spectrum of COVID-19 is not only limited to local pneumonia but also represents multiple organ involvement, with potential for systemic complications. One year after the pandemic, pathophysiological knowledge has evolved, and many therapeutic advances have occurred, but mortality rates are still elevated in severe/critical COVID-19 cases. Mesenchymal stromal cells (MSCs) can exert immunomodulatory, antiviral, and pro-regenerative paracrine/endocrine actions and are therefore promising candidates for MSC-based therapies. In this review, we discuss the rationale for MSC-based therapies based on currently available preclinical and clinical evidence of safety, potential efficacy, and mechanisms of action. Finally, we present a critical analysis of the risks, limitations, challenges, and opportunities that place MSC-based products as a therapeutic strategy that may complement the current arsenal against COVID-19 and reduce the pandemic’s unmet medical needs.

show abstract

Mesenchymal stem cells in the treatment of coronavirus-induced pneumonia (COVID-19)

Abstract: Células-tronco mesenquimais no tratamento da pneumonia induzida pelo coronavírus (COVID-19

Cited by 9 publications

References 5 publications

Immunomodulatory and Anti-fibrotic Effects Following the Infusion of Umbilical Cord Mesenchymal Stromal Cells in a Critically Ill Patient With COVID-19 Presenting Lung Fibrosis: A Case Report

Immunomodulatory and Anti-fibrotic Effects Following the Infusion of Umbilical Cord Mesenchymal Stromal Cells in a Critically Ill Patient With COVID-19 Presenting Lung Fibrosis: A Case Report

Intravenous Administration of Umbilical Cord Mesenchymal Stromal Cells in Advanced-stage Critical COVID-19: a Case Report

Is there a place for mesenchymal stromal cell-based therapies in the therapeutic armamentarium against COVID-19?

Contact Info

Product

Resources

About