Critical roles of cytokine storm and bacterial infection in patients with COVID-19: therapeutic potential of mesenchymal stem cells

Abstract

The severe acute respiratory syndrome coronavirus 2 has been a shocking disaster for healthcare systems worldwide since December 2019. This virus can affect all systems of the body and its symptoms vary from a simple upper respiratory infection to fatal complications including end-organ damage. On the other hand, the normal immune system plays a pivotal role in the recovery of infectious diseases such as COVID-19. However, occasionally, exaggerated immune system inflammation and an excessive synthesis of cytokines, known as a "cytokine storm," can deteriorate the patient's clinical condition. Secondary bacterial co-infection is another problem in COVID-19 which affects the prognosis of patients. Although there are a few studies about this complication, they suggest not using antibiotics commonly, especially broad-spectrum ones. During this pandemic, various approaches and therapeutics were introduced for treating COVID-19 patients. However, available treatments are not helpful enough, especially for complicated cases. Hence, in this era, cell therapy and regenerative medicine will create new opportunities. Therefore, the therapeutic benefits of mesenchymal stem cells, especially their antimicrobial activity, will help us understand how to treat COVID-19. Herein, mesenchymal stem cells may stop the immune system from becoming overactive in COVID-19 patients. On the other side, the stem cells' capacity for repair could encourage natural healing processes.

"Multidrug-Resistant Bacteria Related to Covid-19 Infection: A Minireview"

“…It results from the association of molecules such as interleukins, interferons, chemokines, and TNF-α in patients with COVID-19. A significant elevation of inflammatory markers were observed in patients who received antibiotics, which Have been pointed out as a possible aggravation of the cytokine storm caused by COVID-19 [16,21,22]. Bacteria are able to successfully cause secondary infections in COVID-19 by their virulence factors, such as membrane proteins, secretory systems, adhesins, and glycoconjugates.…”

Intestinal Damage, Inflammation and Microbiota Alteration during COVID-19 Infection

“…A state of hyper-inflammation and cytokine storm syndrome in patients can exacerbate their condition and complicate the ongoing therapeutic approaches [ 37 ]. The process involves the infected cells releasing a large number of inflammatory markers and cytokines such as Interleukin 2 and 7, tumor necrosis factor-alpha, granulocyte colony stimulating factor, interferon gamma inducible protein 10, monocyte chemoattractant protein 1 and macrophage inflammatory protein 1 alpha [ 38 , 39 ].…”