Renal Involvement and Outcomes in Severe COVID-19 Patients After Stem Cell Jet-Nebulization

Abstract

Introduction:The COVID-19 pandemic presented an unprecedented challenge to identify effective drugs and means for their prevention and management. It is more difficult in severe cases due to complications in various vital organs such as the kidneys. Methods: An analytical study was carried out within the framework of the clinical trial "SENTAD-COVID Study" (ClinicalTrial.org, NCT04473170), whose objective was to describe acute kidney injury (AKI) in severe patients with COVID-19 and its relationship with clinical outcomes. A novel stem cells treatment for COVID-19 patients using an autologous peripheral blood nonhematopoietic-enriched stem cells cocktail was developed by the research team of the Abu Dhabi Stem Cells Center and applied at four Abu Dhabi Health Service Company hospitals. The sample consisted of the severe COVID-19 recruited patients: 20 in the experimental arm (Group A) and 24 controls (Group B). Both groups received COVID-19 standard treatment. Results: 29.5% of the patients studied suffered AKI. Mortality was lower in group A compared to the control group (20% vs. 30%, respectively), group A showed 25% AKI while group B 35%, sepsis was significantly lower in the treated group A compared to controls (25% vs. 35%; p=0.0095) Hazard Ratio=0.38, (95% CI: 0.16-0.86), given a Number Needed to Treat=2.5 patients. Group A had a significant reduction in inflammation markers at 25 days compared to the day of recruitment: C-Reactive Protein (median: 207.05 mg/L vs. 27.30 mg/L), IL-6 (median: 355.80 pg/L vs. 35.87 pg/L), and group A was the only one that presented a better proportion of patient with the recovery to normal values of the Neutrophil/Lymphocyte Ratio at 25 days, from 100% to 71.42% p=0.0108. Conclusions: One-third of the patients studied suffered AKI, group A patients showed a clear tendency to improve compared to controls, suggesting that the proposed therapy promotes healing and early recovery in severe COVID-19, which might be related to the anti-inflammatory effect of cellular therapy.