The clinical efficacy and safety of mesenchymal stromal cells for patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

Ching-Yi Chen; Wang-Chun Chen; Chi-Kuei Hsu; Chien-Ming Chao; Chih-Cheng Lai

doi:10.1016/j.jiph.2022.07.001

The clinical efficacy and safety of mesenchymal stromal cells for patients with COVID-19: A systematic review and meta-analysis of randomized controlled trials

J Infect Public Health. 2022 Aug;15(8):896-901. doi: 10.1016/j.jiph.2022.07.001. Epub 2022 Jul 7.

Authors

Ching-Yi Chen¹, Wang-Chun Chen², Chi-Kuei Hsu³, Chien-Ming Chao⁴, Chih-Cheng Lai⁵

Affiliations

¹ School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
² Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, Taiwan; Department of Pharmacy, E-Da Hospital, Kaohsiung, Taiwan.
³ School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan, College of Medicine, I-Shou University, Kaohsiung, Taiwan; Department of Critical Care Medicine, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
⁴ Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Taiwan.
⁵ Division of Hospital Medicine, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan. Electronic address: dtmed141@gmail.com.

Abstract

Objectives: This meta-analysis of randomized controlled trials (RCTs) investigated the usefulness of mesenchymal stromal cells (MSCs) to treat patients with COVID-19.

Methods: PubMed, Embase, Ovid MEDLINE, the Cochrane Library, and Clinicaltrials.gov were searched for RCTs published before November 7, 2021. Only RCTs that compared the clinical efficacy and safety of MSCs with other alternative treatments or placebos in the treatment of patients with COVID-19 were included.

Results: Six RCTs were included, in which the MSC and control groups consisted of 158 and 135 patients, respectively. The patients who received MSCs had a significantly lower 28-day mortality rate (7.6% vs 21.5%; OR, 0.18; 95% CI, 0.06-0.52; I² = 0%) and significantly higher clinical improvement rate (OR, 6.05; 95% CI, 2.31-15.83; I² = 0%) than the controls. The patients who received MSCs were associated with a similar risk of adverse events (AEs) and serious AEs to the control group (AEs: OR, 33; 95% CI, 0.09-1.18; I² = 59%; serious AEs: OR, 0.30; 95% CI, 0.02-4.41; I² = 53%).

Conclusions: MSC treatment may help to improve the clinical outcomes of patients with COVID-19. In addition, MSC treatment appears to be a safe therapeutic option for patients with COVID-19.

Keywords: COVID-19; Mesenchymal stromal cell; Mortality; SARS-CoV-2.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

COVID-19* / therapy
Humans
Mesenchymal Stem Cells*
Randomized Controlled Trials as Topic
Treatment Outcome