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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; López-Parra, Miriam; Monedero, Pablo; Mata-Martínez, Carmen; Santos, Arnoldo; Sagredo, Víctor; Alvarez-Avello, José Manuel; Guerrero, José Eugenio; Pérez-Calvo, César; Sánchez-Hernández, Miguel Vicente; Del-Pozo, José Luis; Andreu, Enrique J.; Fernández-Santos, María Eugenia; Soria-Juan, Barbara; Hernández-Blasco, Luis M.; Andreu, Etelvina; Sempere, José M.; Zapata, Agustín G.; Moraleda, José M.; Soria, Bernat; Fernández-Avilés, Francisco; García-Olmo, Damián; Prósper, Felipe
Entity
UAM. Departamento de Cirugía
Publisher
Elsevier
Date
2020-07-10
Citation
10.1016/j.eclinm.2020.100454
EClinicalMedicine (2020): 100454
 
 
 
ISSN
2589-5370
DOI
10.1016/j.eclinm.2020.100454
Editor's Version
https://doi.org/10.1016/j.eclinm.2020.100454
Subjects
COVID-19; SARS-CoV-2; Pneumonia; Mechanical ventilation; Mesenchymal stromal cells; Cellular therapy; Medicina
URI
http://hdl.handle.net/10486/691678
Rights
© 2020 The Authors. Published by Elsevier Ltd.

Licencia de Creative Commons
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
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Google™ Scholar:Sánchez-Guijo, Fermín - García-Arranz, Mariano - López-Parra, Miriam - Monedero, Pablo - Mata-Martínez, Carmen - Santos, Arnoldo - Sagredo, Víctor - Alvarez-Avello, José Manuel - Guerrero, José Eugenio - Pérez-Calvo, César - Sánchez-Hernández, Miguel Vicente - Del-Pozo, José Luis - Andreu, Enrique J. - Fernández-Santos, María Eugenia - Soria-Juan, Barbara - Hernández-Blasco, Luis M. - Andreu, Etelvina - Sempere, José M. - Zapata, Agustín G. - Moraleda, José M. - Soria, Bernat - Fernández-Avilés, Francisco - García-Olmo, Damián - Prósper, Felipe

This item appears in the following Collection(s)

  • Producción científica en acceso abierto de la UAM [14721]

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