A synergistic role of convalescent plasma and mesenchymal stem cells in the treatment of severely ill COVID-19 patients: a clinical case report

Abstract

Acute respiratory distress syndrome virus-2 (SARS-CoV-2) responsible for coronavirus disease 2019 (COVID-19) infection, which causes global public health emergencies, has sped widely for more than 5 months and has the risk of long-term transmission. No effective treatment has been discovered to date. In the cases we report, the patient continued to deteriorate even after administration of antiviral drugs such as lopinavir/ritonavir, interferon-α, and ribavirin, as well as intravenous injection of meropenem, methylprednisolone, and immunoglobulin. So, we infused the patient with convalescent plasma (CP), and the absolute lymphocyte count increased the next day and returned to normal on the fourth day. Followed by intravenous infusion of mesenchymal stem cells (MSCs), bilateral infiltrates were absorbed and the pulmonary function was significantly improved. We note that the intravenous infusion of CP and MSCs for the treatment of severe COVID-19 patients may have synergistic characteristics in inhibiting cytokine storm, promoting the repair of lung injury, and recovering pulmonary function. We hope to provide a reference for the research direction of COVID-19 clinical strategies.

Convalescent plasma may be a possible treatment for COVID-19: A systematic review

“…Following removing duplicates and screening of titles and abstracts, we evaluated 153 articles in full text. Among these, we found 45 relevant articles (4RCTs, 11 controlled NRSIs, 7 non-controlled NRSIs and 23 case reports) [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] . Extracted details are presented in Table 1 (RCTs, controlled NRSIs, and non-controlled NRSIs) and table 2 (case report(series)).…”

“… Clinical recovery and discharge from hospital. No adverse reactions Abdullah HM et al [51] Iraq Case series(n = 2) 46y/M; 56y/M 200 ml – case1:10 days; case2: not reported Severe illness Clinical recovery and discharge from hospital No AEs Peng H et al [52] China Case report 66y/F 200 ml,twice Greater than 1:160. 10 days Severe illness On the fourth day after CPT, the absolute lymphocyte count returned to normal.…”

Stem cell therapy in COVID-19: Pooled evidence from SARS-CoV-2, SARS-CoV, MERS-CoV and ARDS: A systematic review

“… This was the first coronavirus case treated with umbilical cord cells reported from China. Liang et al,2020 [ 45 ] Case report Completed COVID-19 65-year-old woman hUCMSCs administrated intravenously for three times with antibiotics and thymosin α1 NA Reduced serum levels of bilirubin, CRP, ALT/AST along with improvement of vital signs. Decreased counts of white blood cells, and neutrophils and increase in lymphocyte count and throat swabs tests reported negative Peng et al, 2020 [ 46 ] Case report Completed COVID-19 66-year old female Convalescent plasma along with UC-MSCs Absolute lymphocyte count was improved after twice administration of convalescent plasma and no infusion or allergic reactions were seen after UC-MSC administration.…”

Intravenous Administration of Umbilical Cord Mesenchymal Stromal Cells in Advanced-stage Critical COVID-19: a Case Report

“…MSC-based therapy protocols to treat COVID-19 have been directed mainly to patients with moderate and severe clinical presentations [9][10][11][12][13][14][15][16][17][18]. Few numbers of studies included critically ill patients with COVID-19 under invasive mechanical ventilation [24][25][26].…”

“…Mesenchymal stromal cells (MSCs) have been evaluated in compassionate use or clinical trials to treat COVID-19 pneumonia [9][10][11][12][13][14][15][16][17][18]. The rationale is to direct the immunomodulatory properties of MSCs to control the hyperin ammatory state and improve respiratory function.…”