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Meta-Analysis
. 2022 Jul 20;11(7):688-703.
doi: 10.1093/stcltm/szac032.

Efficacy and Safety of MSC Cell Therapies for Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

Wenchun Qu  1   2 , Zhen Wang  3   4 , Erica Engelberg-Cook  5 , Dan Yan  1 , Abu Bakar Siddik  1 , Guojun Bu  2   5 , Julie G Allickson  6 , Eva Kubrova  7 , Arnold I Caplan  8 , Joshua M Hare  9 , Camillo Ricordi  10 , Carl J Pepine  11 , Joanne Kurtzberg  12 , Jorge M Pascual  13 , Jorge M Mallea  13 , Ricardo L Rodriguez  14 , Tarek Nayfeh  3   4 , Samer Saadi  3   4 , Ravindra V Durvasula  15 , Elaine M Richards  16 , Keith March  11 , Fred P Sanfilippo  17
Affiliations
Meta-Analysis

Efficacy and Safety of MSC Cell Therapies for Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis

Wenchun Qu et al. Stem Cells Transl Med. .

Abstract

MSC (a.k.a. mesenchymal stem cell or medicinal signaling cell) cell therapies show promise in decreasing mortality in acute respiratory distress syndrome (ARDS) and suggest benefits in treatment of COVID-19-related ARDS. We performed a meta-analysis of published trials assessing the efficacy and adverse events (AE) rates of MSC cell therapy in individuals hospitalized for COVID-19. Systematic searches were performed in multiple databases through November 3, 2021. Reports in all languages, including randomized clinical trials (RCTs), non-randomized interventional trials, and uncontrolled trials, were included. Random effects model was used to pool outcomes from RCTs and non-randomized interventional trials. Outcome measures included all-cause mortality, serious adverse events (SAEs), AEs, pulmonary function, laboratory, and imaging findings. A total of 736 patients were identified from 34 studies, which included 5 RCTs (n = 235), 7 non-randomized interventional trials (n = 370), and 22 uncontrolled comparative trials (n = 131). Patients aged on average 59.4 years and 32.2% were women. When compared with the control group, MSC cell therapy was associated with a reduction in all-cause mortality (RR = 0.54, 95% CI: 0.35-0.85, I 2 = 0.0%), reduction in SAEs (IRR = 0.36, 95% CI: 0.14-0.90, I 2 = 0.0%) and no significant difference in AE rate. A sub-group with pulmonary function studies suggested improvement in patients receiving MSC. These findings support the potential for MSC cell therapy to decrease all-cause mortality, reduce SAEs, and improve pulmonary function compared with conventional care. Large-scale double-blinded, well-powered RCTs should be conducted to further explore these results.

Keywords: COVID; MSC; cytokine storm; hospital recovery; pulmonary.

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Figures

Figure 1.
Figure 1.
PRISMA 2009 flow diagram.
Figure 2.
Figure 2.
Pooled estimate of all-cause mortality.
Figure 3.
Figure 3.
Pooled estimate of all-cause serious adverse events.
Figure 4.
Figure 4.
Pooled estimate of all-cause adverse event.
See this image and copyright information in PMC

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