Tang Chaozhi, Dziedzic Arkadiusz, Khatib Mahalaqua Nazli, Alhumaid Saad, Thangavelu Lakshmi, Parameswari R P, Satapathy Prakasini, Zahiruddin Quazi Syed, Rustagi Sarvesh, Alanazi Maha Afri, Al-Thaqafy Majid S, Hazazi Ali, Alotaibi Jawaher, Al Faraj Nehad J, Al-Zaki Nisreen A, Al Marshood Mona J, Al Saffar Thuria Y, Alsultan Khadija A, Al-Ahmed Shamsah H, Rabaan Ali A
College of Life Science, Henan Normal University, Xinxiang, Henan, China.
Department of Conservative Dentistry with Endodontics, Medical University of Silesia, Katowice, Poland.
Int J Surg. 2024 Oct 1;110(10):6402-6417. doi: 10.1097/JS9.0000000000001786.
COVID-19 has presented significant obstacles to healthcare. Stem cell therapy, particularly mesenchymal stem cells, has emerged as a potential treatment modality due to its immunomodulatory and regenerative properties. This umbrella review aims to synthesize current evidence from systematic reviews on the safety and efficacy of stem cell therapy in COVID-19 treatment.
A thorough literature search was performed across Embase, PubMed, Cochrane, and Web of Science from December 2019 to February 2024. Systematic reviews focusing on the use of stem cell therapy for COVID-19 were included. Evidence was synthesized by meta-analysis using R software (V 4.3) for each outcome. The certainty of evidence was assessed using the GRADE approach.
A total of 24 systematic reviews were included. Stem cell therapy was associated with reduced mortality [risk ratio (RR) 0.72, 95% CI: 0.60-0.86]; shorter hospital stays (mean difference -4.00 days, 95% CI: -4.68 to -3.32), and decreased need for invasive ventilation (RR 0.521, 95% CI: 0.320-0.847). Symptom remission rates improved (RR 1.151, 95% CI: 0.998-1.330), and a reduction in C-reactive protein levels was noted (standardized mean difference -1.198, 95% CI: -2.591 to 0.195), albeit with high heterogeneity. For adverse events, no significant differences were found between stem cell therapy and standard care (RR 0.87, 95% CI: 0.607-1.265). The certainty of evidence ranged from low to moderate.
Stem cell therapy demonstrates a potential benefit in treating COVID-19, particularly in reducing mortality and hospital stay duration. Despite these promising findings, the evidence is varied, and future large-scale randomized trials are essential to confirm the efficacy and optimize the therapeutic protocols for stem cell therapy in the management of the disease. The safety profile is encouraging, with no significant increase in adverse events, suggesting a viable avenue for treatment expansion.
新型冠状病毒肺炎（COVID-19）给医疗保健带来了重大障碍。干细胞疗法，尤其是间充质干细胞，因其免疫调节和再生特性，已成为一种潜在的治疗方式。本伞状综述旨在综合系统评价中关于干细胞疗法治疗COVID-19的安全性和有效性的现有证据。
于2019年12月至2024年2月在Embase、PubMed、Cochrane和Web of Science数据库中进行了全面的文献检索。纳入了关注干细胞疗法用于COVID-19治疗的系统评价。使用R软件（V 4.3）对每个结局进行荟萃分析来综合证据。采用GRADE方法评估证据的确定性。
共纳入24项系统评价。干细胞疗法与降低死亡率相关[风险比（RR）0.72，95%置信区间（CI）：0.60 - 0.86]；缩短住院时间（平均差 -4.00天，95% CI：-4.68至 -3.32），以及减少有创通气需求（RR 0.521，95% CI：0.320 - 0.847）。症状缓解率有所提高（RR 1.151，95% CI：0.998 - 1.330），并且观察到C反应蛋白水平降低（标准化平均差 -1.198，95% CI：-2.591至0.195），尽管存在高度异质性。对于不良事件，干细胞疗法与标准治疗之间未发现显著差异（RR 0.87，95% CI：0.607 - 1.265）。证据的确定性范围为低到中等。
干细胞疗法在治疗COVID-19方面显示出潜在益处，特别是在降低死亡率和缩短住院时间方面。尽管有这些有前景的发现，但证据存在差异，未来大规模随机试验对于确认疗效和优化干细胞疗法在该疾病管理中的治疗方案至关重要。安全性令人鼓舞，不良事件没有显著增加，表明这是一个可行的治疗扩展途径。
