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人脐带间充质干细胞治疗重症 COVID-19 患者:出院后 3 个月随访研究。

Human Umbilical Cord Mesenchymal Stromal Cell Treatment of Severe COVID-19 Patients: A 3-Month Follow-Up Study Following Hospital Discharge.

机构信息

Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Department of Respiratory Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.

出版信息

Stem Cells Dev. 2021 Aug 1;30(15):773-781. doi: 10.1089/scd.2021.0015. Epub 2021 Jun 29.

Abstract

Previously, we demonstrated the therapeutic effects of human umbilical cord mesenchymal stromal cells (hUC-MSCs) in severe coronavirus disease 2019 (COVID-19) patients. In this 3-month follow-up study, we examined discharged patients who had received hUC-MSC therapy to assess the safety of this therapy and the health-related quality of life (HRQL) of these patients. The follow-up cohort consisted of 28 discharged severe COVID-19 patients who received either the standard treatment (the control group) or the standard treatment plus hUC-MSC therapy. We examined liver function, kidney function, pulmonary function, coagulation, tumor markers, and vision. We also conducted electrocardiography (ECG) analysis, let the patients answer the St. George's Respiratory Questionnaire (SGRQ), and performed computed tomography (CT) imaging for assessing the lung changes. No obvious adverse effects were observed in the hUC-MSC group after 3 months. Measurements of blood routine index, C-reactive protein and procalcitonin, liver and kidney function, coagulation, ECG, tumor markers, and vision were almost within the normal ranges in both the treatment and control groups. Forced expiratory volumes in 1 s (FEV1) (% of predicted) were 71.88% ± 8.46% and 59.45% ± 27.45% in the hUC-MSC and control groups ( < 0.01), respectively, and FEV1/forced vital capacity (FEV1/FVC) ratios were 79.95% ± 8.00% and 58.97% ± 19.16% in the hUC-MSC and control groups, respectively ( < 0.05). SGRQ scores were lower in the hUC-MSC group than in the control group (15.25 ± 3.69 vs. 31.9 ± 8.78,  < 0.05). The rate of wheezing in the hUC-MSC group was also significantly lower than that in the control group (37.5% vs. 75%,  < 0.05). There were no significant differences in CT scores between the two groups (0.60 ± 0.88 vs. 1.00 ± 1.31,  = 0.917). Overall, the intravenous transplantation of hUC-MSCs accelerated partial pulmonary function recovery and improved HRQL, indicating relative safety and preliminary efficacy of this treatment for patients with severe COVID-19.

摘要

先前,我们已经证明了人脐带间充质干细胞(hUC-MSCs)在严重 2019 年冠状病毒病(COVID-19)患者中的治疗效果。在这项为期 3 个月的随访研究中,我们对接受 hUC-MSC 治疗的出院患者进行了检查,以评估这种治疗的安全性和这些患者的健康相关生活质量(HRQL)。随访队列由 28 名接受标准治疗(对照组)或标准治疗加 hUC-MSC 治疗的出院严重 COVID-19 患者组成。我们检查了肝功能、肾功能、肺功能、凝血、肿瘤标志物和视力。我们还进行了心电图(ECG)分析,让患者回答圣乔治呼吸问卷(SGRQ),并进行计算机断层扫描(CT)成像以评估肺部变化。在 3 个月后,hUC-MSC 组没有观察到明显的不良反应。治疗组和对照组的血常规指标、C 反应蛋白和降钙素、肝肾功能、凝血、心电图、肿瘤标志物和视力的测量值几乎都在正常范围内。hUC-MSC 组用力呼气量 1 秒(FEV1)(预计值的百分比)为 71.88%±8.46%,对照组为 59.45%±27.45%( <0.01),FEV1/用力肺活量(FEV1/FVC)比值 hUC-MSC 组为 79.95%±8.00%,对照组为 58.97%±19.16%( <0.05)。hUC-MSC 组的 SGRQ 评分低于对照组(15.25±3.69 与 31.9±8.78, <0.05)。hUC-MSC 组喘息的发生率也明显低于对照组(37.5%与 75%, <0.05)。两组 CT 评分无显著差异(0.60±0.88 与 1.00±1.31,  =0.917)。总体而言,hUC-MSCs 的静脉移植加速了部分肺功能恢复,改善了 HRQL,表明这种治疗对严重 COVID-19 患者具有相对安全性和初步疗效。

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