New Translational Trends in Personalized Medicine: Autologous Peripheral Blood Stem Cells and Plasma for COVID-19 Patient

Abstract

The COVID-19 pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), still remains a severe threat. At the time of writing this paper, the second infectious wave has caused more than 280,000 deaths all over the world. Italy was one of the first countries involved, with more than 200,000 people reported as infected and 30,000 deaths. There are no specific treatments for COVID-19 and the vaccine still remains somehow inconclusive. The world health community is trying to define and share therapeutic protocols in early and advanced clinical stages. However, numbers remain critical with a serious disease rate of 14%, ending with sepsis, acute respiratory distress syndrome (ARDS), multiple organ failure (MOF) and vascular and thromboembolic findings. The mortality rate was estimated within 2-3%, and more than double that for individuals over 65 years old; almost one patient in three dies in the Intensive Care Unit (ICU). Efforts for effective solutions are underway with multiple lines of investigations, and health authorities have reported success treating infected patients with donated plasma from survivors of the illness, the proposed benefit being protective antibodies formed by the survivors. Plasma transfusion, blood and stem cells, either autologous or allograft transplantation, are not novel therapies, and in this short paper, we propose therapeutic autologous plasma and peripheral blood stem cells as a possible treatment for fulminant COVID-19 infection.

Keywords: COVID-19; SARS-CoV-2; arterial blood gas (ABG); autologous plasma and peripheral blood stem cells; clinical biochemistry and molecular clinical biology; laboratory medicine.

Figure 1

(A–F) A 56-year-old man presented with fever for 3 days, accompanied by anuria, asthenia, general malaise and positive to COVID-19 (A–E) Pulmonary HRCT obtained on 18 November 2020 showed multiple peripheral patchy ground glass opacities bilaterally being the lower lobes the most involved areas in (F).

Figure 2

(A–C) Pulmonary HRCT scan obtained on day 35 from symptom onset (23 December 2020) shows almost complete resolution of the initial presentation.

Figure 3

(A–C) Pulmonary non-contrast enhanced chest CT scan obtained on day 60 from symptom onset (16 February 2021), shows continued and completed resolution without residuals. Parenchymal, mediastinum, and peripheral (A,B), lower lobe I opacities and bands are not observed (A,B).

Figure 4

(A–C) A 56-year-old man from “SG Moscati Hospital”, Taranto, presented with fever, cough, and chest pain. Pulmonary HRCT at presentation on 3 March 2020 showed extensive peripheral predominant ground-glass opacities in both upper lobes (A); On 26 March 2020, a follow-up HRCT showed similar anomalous ground glass opacities (B) HRCT obtained on 14 May 2020 showed organizing changes with decrease in extent of the ground-glass opacities and increasing parenchymal consolidations (C).