Cell-Based Therapy for Severe COVID-19 Patients: Clinical Trials and Cost-Utility.

The race among countries and companies to develop efficacious vaccines and therapeutics for the COVID-19 is ongoing fast, with many trials underway. Among this, cell-based therapy is focused on moderate to severe phases of COVID-19, and there have been promising outcomes. Mesenchymal stem cells (MSCs) due to their pro/anti-inflammatory and immune-modulatory behavior, Natural Killer (NK) cells thanks to their capacity of lysing virus-infected cells and regulate the resulting immune response, Dendritic cells thanks to immunotherapy and cell-based vaccine engineering, SARS-CoV2-specific T cells due to stimulate and promote the immune system and MSC-derived exosomes because of cell-free therapy and beneficial manufacturing aspects, hold great promises for cell-based therapy applications for treating COVID-19 and similar viral infections. Moreover, recently, an innovative approach to COVID-19 based on engineered human MSC has been introduced, which is continuously evacuated and degraded by the body's immune system during the antigen recognition process. However, the economic situation of governments and nations, and the cost of therapeutics influence the clinical approaches to manage and exit from this pandemic. This summary describes cell-based clinical trials and the cost-utility aspects of cell therapy. In this regard, limited clinical studies have been reported; while, several clinical trials have been approved for starting phases 2 and 3 of their trials for treating COVID-19 patients with acute respiratory distress syndrome. Regarding the cost of cell therapy, many believe that the high cost of cell-based therapy will decrease substantially. Hence, there are hopes that cellular therapy can be approved soon for the treatment of viral diseases such as COVID-19. Graphical abstract.