Currently, the world has been devastated by an unprecedented pandemic in this century. The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the agent of coronavirus disease 2019 (COVID-19), has been causing disorders, dysfunction and morphophysiological alterations in multiple organs as the disease evolves. There is a great scientific community effort to obtain a therapy capable of reaching the multiple affected organs in order to contribute for tissue repair and regeneration. In this regard, mesenchymal stem cells (MSCs) have emerged as potential candidates concerning the promotion of beneficial actions at different stages of COVID-19. MSCs are promising due to the observed therapeutic effects in respiratory preclinical models, as well as in cardiac, vascular, renal and nervous system models. Their immunomodulatory properties and secretion of paracrine mediators, such as cytokines, chemokines, growth factors and extracellular vesicles allow for long range tissue modulation and, particularly, blood-brain barrier crossing. This review focuses on SARS-CoV-2 impact to lungs, kidneys, heart, vasculature and central nervous system while discussing promising MSC's therapeutic mechanisms in each tissue. In addition, MSC's therapeutic effects in high-risk groups for COVID-19, such as obese, diabetic and hypertensive patients are also explored.

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Introduction: The emergence of a new coronavirus has changed the world and caused one of the biggest global health crises of the past 100 years. The protagonist of the pandemic, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is responsible for the coronavirus disease 2019 (Covid-19), which leads to dysfunctions in a plethora of systems, especially in severe cases. Therefore, researchers and healthcare professionals are making great efforts to develop a therapy that helps the many organs affected by the disease, for which mesenchymal stem cells (MSCs) arise as promising candidates. MSCs can offer benefits at different phases of Covid-19, since they have important anti-inflammatory and tissue repair properties. Objective: This review aims to elucidate how MSCs can contribute in the Covid-19 scenario by considering their properties and mechanisms of action. Methods: A review of the scientific literature was conducted on electronic databases, such as PubMed, Scielo and Web of Science, in the period of 2020-2021. Results: Therapeutic effects of MSCs in preclinical models of respiratory, nervous, renal, and cardiovascular systems were observed. Conclusion: MSCs can be a therapeutic resource for patients with severe Covid-19.Keywords: SARS-CoV-2; Covid-19; Mesenchymal stem cells; Immunomodulation; Cell therapy.