Clinical remission of a critically ill COVID-19 patient treated by human umbilical cord mesenchymal stem cells: A case report

Abstract

Rationale: The COVID-19 cases increased very fast in January and February 2020. The mortality among critically ill patients, especially the elder ones, is relatively high. Considering many patients died of severe inflammation response, it is urgent to develop effective therapeutic strategies for these patients. The human umbilical cord mesenchymal stem cells (hUCMSCs) have shown good capabilities to modulate the immune response and repair the injured tissue. Therefore, investigating the potential of hUCMSCs to the treatment of COVID-19 critically ill patients is necessary.

Patient concerns: A 65-year-old woman felt fatigued and had a fever with body temperature of 38.2C, coughed up white foaming sputum. After 1 day, she had chest tightness with SPO2 of 81%, and blood pressure of 160/91 mm Hg.

Diagnose: According to the guideline for the diagnosis and treatment of 2019 novel coronavirus infected pneumonia (Trial 4th Edition), COVID-19 was diagnosed, based on the real-time RT-PCR test of SARS-CoV-2.

Interventions: After regular treatment for 12 days, the inflammation symptom of the patient was still very severe and the potential side effects of corticosteroid were observed. Then, allogenic hUCMSCs were given 3 times (5 × 10 cells each time) with a 3-day interval, together with thymosin α1 and antibiotics daily injection.

Outcomes: After these treatments, most of the laboratory indexes and CT images showed remission of the inflammation symptom. The patient was subsequently transferred out of ICU, and the throat swabs test reported negative 4 days later.

Lessons: These results indicated the clinical outcome and good tolerance of allogenic hUCMSCs transfer.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1

The major symptoms and treatment of the critically ill COVID-19 patient.

Figure 2

The dynamic changes of the immune cell counts of the patient. The arrows indicate the day of hUCMSCs therapy. To the white blood cell (normal range 3.5–9.5 × 109/L), neutrophil (normal range 1.8–6.3 × 109/L) and D-dimer (normal range 0–0.5 μg/mL), the dash line indicates upper threshold. While to the lymphocyte (normal range 1.1–3.2 × 109/L) and T cell subsets, the dash line indicates lower threshold. hUCMSC = human umbilical cord mesenchymal stem cell.

Figure 3

The typical CT images of the lung. A1–A3, CT images on day 2 indicate that there are lesions and mass density increasing shadow in both left and right lung. The ground-glass opacity, nonhomogeneous density, and air bronchus can be seen in the right lung. B1–B3, CT images on day 20 indicate the relief in both left and right lung. Only some Stripe shadow and small pieces of ground-glass opacity can be seen. C1–C3, CT images on day 25 indicate the further relief in both left and right lung. Most of the ground-glass opacity lightened, or even disappeared.