Department of Medical Genetics, Faculty of Medicine, Haliç University, İstanbul, Turkey.
Department of Medical Biology, Faculty of Medicine, Haliç University, İstanbul, Turkey.
Stem Cell Rev Rep. 2021 Oct;17(5):1917-1925. doi: 10.1007/s12015-021-10214-x. Epub 2021 Jul 28.
Treatment for COVID-19 is still urgent need for the critically ill and severe cases. UC-MSC administration has a therapeutic benefit for severe COVID-19 patients even in the recovery period. In this paper, we aimed to present our clinical experience with UC-MSC treatment in severe and critical severe COVID-19 patients.
In this study we evaluated the clinical outcome of severe/critically severe 210 COVID-19 patients treated with UC-MSCs, 1-2 × 10 per kilogram to 210 patients from 15/10/2020 until 25/04/2021.
Out of 99 critically severe intubated patients we have observed good clinical progress/discharged from ICU in 52 (52.5%) patients. Where as 86 (77.5%) of 111 severe unintubated patients discharged from ICU. Intubated 47 (47.5%) patients and unintubated 25 (22.5%) patients pass away. Significantly higher survival was observed in patients who underwent UC-MSCs before intubation (OR = 1.475, 95% CI = 1.193-1.824 p < 0.001). It was observed that the SaO parameter tended to improve after UC-MSC therapy compared to all groups. But SaO parameter between intubated and unintubated groups was not statistically significant (p > 0.05), while in discharged cases SaO parameter was statistically significant (p = 0.01). Besides, there was a statistically significant relation with intubation status, age (OR = 3.868, 95% CI = 0.574-7.152 p = 0.02) and weigh (OR = 6.768, 95% CI = 3.423-10.112 p < 0.001) thus presented an elevated risk for COVID-19. The linear regression analysis confirmed that the high weight was associated with the risk of intubation in COVID-19 (p = 0.001).
According to our results and from recent studies, UC-MSC treatment is safe with high potential to be used as an added therapeutic treatment for severe COVID-19 patients. Our experience showed that UC-MSC therapy may restore oxygenation and downregulate cytokine storm in patients hospitalized with severe COVID-19. We advice wider randomised studies to discover the detailed therapeutic pathophysiology of the MSCs on COVID-19 patients. MSCs transplantation improves the damaging effects of the cytokine storm through immunomodulation and improving tissue and organ repair. Severe patients who were unintubated were in the Phase I, while critical patients who were intubated were in the Phase II. The figure is created via biorender application, ( BioRender.com ).
对于危重症和重症 COVID-19 患者，仍迫切需要治疗方法。UC-MSC 治疗对重症 COVID-19 患者甚至在恢复期都有治疗益处。本文旨在介绍我们在重症和危重症 COVID-19 患者中使用 UC-MSC 治疗的临床经验。
在这项研究中，我们评估了 210 名 COVID-19 重症/危重症患者接受 UC-MSCs 治疗的临床结果，每位患者 1-2×10 个细胞/kg，从 2020 年 10 月 15 日至 2021 年 4 月 25 日治疗 210 名患者。
在 99 名危重症需插管的患者中，我们观察到 52 名（52.5%）患者临床状况明显好转并从 ICU 出院。而在 111 名非插管重症患者中，有 86 名（77.5%）出院。47 名插管患者和 25 名非插管患者死亡。在接受 UC-MSCs 治疗前插管的患者中，存活率明显更高（OR=1.475，95%CI=1.193-1.824，p<0.001）。与所有组相比，接受 UC-MSCs 治疗后 SaO 参数趋于改善。但插管组和非插管组之间的 SaO 参数无统计学意义（p>0.05），而出院组 SaO 参数有统计学意义（p=0.01）。此外，与插管状态、年龄（OR=3.868，95%CI=0.574-7.152，p=0.02）和体重（OR=6.768，95%CI=3.423-10.112，p<0.001）存在统计学显著关系，因此 COVID-19 风险升高。线性回归分析证实，体重高与 COVID-19 患者插管风险相关（p=0.001）。
根据我们的结果和最近的研究，UC-MSC 治疗是安全的，具有很大的潜力作为重症 COVID-19 患者的附加治疗方法。我们的经验表明，UC-MSC 治疗可能会恢复氧合并下调 COVID-19 住院患者的细胞因子风暴。我们建议进行更广泛的随机研究，以发现间充质干细胞对 COVID-19 患者的详细治疗病理生理学。间充质干细胞移植通过免疫调节和改善组织和器官修复来改善细胞因子风暴的破坏性影响。未插管的重症患者处于第一阶段，而插管的危重症患者处于第二阶段。该图表是通过 biorender 应用程序创建的，（BioRender.com）。
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