Adipose-derived mesenchymal stromal cells for the treatment of patients with severe SARS-CoV-2 pneumonia requiring mechanical ventilation. A proof of concept study
Author
Sánchez-Guijo, Fermín; García Arranz, Mariano Andrés

Entity
UAM. Departamento de CirugíaPublisher
ElsevierDate
2020-07-10Citation
10.1016/j.eclinm.2020.100454
EClinicalMedicine 25 (2020): 100454
ISSN
2589-5370DOI
10.1016/j.eclinm.2020.100454Editor's Version
https://doi.org/10.1016/j.eclinm.2020.100454Subjects
COVID-19; SARS-CoV-2; Pneumonia; Mechanical ventilation; Mesenchymal stromal cells; Cellular therapy; MedicinaRights
© 2020 The Authors. Published by Elsevier Ltd.
Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
Abstract
Identification of effective treatments in severe cases of COVID-19 requiring mechanical ventilation represents an unmet medical need. Our aim was to determine whether the administration of adipose-tissue derived mesenchymal stromal cells (AT-MSC) is safe and potentially useful in these patients.
Methods:
Thirteen COVID-19 adult patients under invasive mechanical ventilation who had received previous antiviral and/or anti-inflammatory treatments (including steroids, lopinavir/ritonavir, hydroxychloroquine and/or tocilizumab, among others) were treated with allogeneic AT-MSC. Ten patients received two doses, with the second dose administered a median of 3 days (interquartile range-IQR- 1 day) after the first one. Two patients received a single dose and another patient received 3 doses. Median number of cells per dose was 0.98 × 106 (IQR 0.50 × 106) AT-MSC/kg of recipient's body weight. Potential adverse effects related to cell infusion and clinical outcome were assessed. Additional parameters analyzed included changes in imaging, analytical and inflammatory parameters. Fundings: First dose of AT-MSC was administered at a median of 7 days (IQR 12 days) after mechanical ventilation. No adverse events were related to cell therapy. With a median follow-up of 16 days (IQR 9 days) after the first dose, clinical improvement was observed in nine patients (70%). Seven patients were extubated and discharged from ICU while four patients remained intubated (two with an improvement in their ventilatory and radiological parameters and two in stable condition). Two patients died (one due to massive gastrointestinal bleeding unrelated to MSC therapy). Treatment with AT-MSC was followed by a decrease in inflammatory parameters (reduction in C-reactive protein, IL-6, ferritin, LDH and d-dimer) as well as an increase in lymphocytes, particularly in those patients with clinical improvement. Treatment with intravenous administration of AT-MSC in 13 severe COVID-19 pneumonia under mechanical ventilation in a small case series did not induce significant adverse events and was followed by clinical and biological improvement in most subjects
Files in this item
Google Scholar:Sánchez-Guijo, Fermín
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García Arranz, Mariano Andrés
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López-Parra, Miriam
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Monedero, Pablo
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Mata-Martínez, Carmen
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Santos, Arnoldo
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Sagredo, Víctor
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Alvarez-Avello, José Manuel
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Guerrero, José Eugenio
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Pérez-Calvo, César
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Sánchez-Hernández, Miguel Vicente
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Del-Pozo, José Luis
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Andreu, Enrique J.
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Fernández-Santos, María Eugenia
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Soria-Juan, Barbara
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Hernández-Blasco, Luis M.
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Andreu, Etelvina
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Sempere, José M.
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Zapata, Agustín G.
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Moraleda, José M.
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Soria, Bernat
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Fernández-Avilés, Francisco
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García Olmo, Damián
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Prósper, Felipe
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