Stem cell-based therapy for COVID-19 and ARDS: a systematic review

Gabriele Zanirati, Laura Provenzi, Lucas Lobraico Libermann, Sabrina Comin Bizotto, Isadora Machado Ghilardi, Daniel Rodrigo Marinowic, Ashok K Shetty, Jaderson Costa Da Costa, Gabriele Zanirati, Laura Provenzi, Lucas Lobraico Libermann, Sabrina Comin Bizotto, Isadora Machado Ghilardi, Daniel Rodrigo Marinowic, Ashok K Shetty, Jaderson Costa Da Costa

Abstract

Despite global efforts to establish effective interventions for coronavirus disease 2019 (COVID-19) and its major complications, such as acute respiratory distress syndrome (ARDS), the treatment remains mainly supportive. Hence, identifying an effective and safe therapy for severe COVID-19 is critical for saving lives. A significant number of cell-based therapies have been through clinical investigation. In this study, we performed a systematic review of clinical studies investigating different types of stem cells as treatments for COVID-19 and ARDS to evaluate the safety and potential efficacy of cell therapy. The literature search was performed using PubMed, Embase, and Scopus. Among the 29 studies, there were eight case reports, five Phase I clinical trials, four pilot studies, two Phase II clinical trials, one cohort, and one case series. Among the clinical studies, 21 studies used cell therapy to treat COVID-19, while eight studies investigated cell therapy as a treatment for ARDS. Most of these (75%) used mesenchymal stem cells (MSCs) to treat COVID-19 and ARDS. Findings from the analyzed articles indicate a positive impact of stem cell therapy on crucial immunological and inflammatory processes that lead to lung injury in COVID-19 and ARDS patients. Additionally, among the studies, there were no reported deaths causally linked to cell therapy. In addition to standard care treatments concerning COVID-19 management, there has been supportive evidence towards adjuvant therapies to reduce mortality rates and improve recovery of care treatment. Therefore, MSCs treatment could be considered a potential candidate for adjuvant therapy in moderate-to-severe COVID-19 cases and compassionate use.

Conflict of interest statement

The authors declare no competing interests.

© 2021. The Author(s).

Figures

Fig. 1. PRISMA flow diagram.
Fig. 1. PRISMA flow diagram.
Summary of evidence search and study selection.

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