Mesenchymal stromal cell therapy for acute respiratory distress syndrome due to coronavirus disease 2019

Stacey Ann Whittaker Brown, Camelia Iancu-Rubin, Adam Aboelela, Alex Abrahams, Elizabeth Burke, Tiffany Drummond, Fred Grossman, Silviu Itescu, Jonathan Lagdameo, Jung Yi Lin, Alexis Mark, John E. Levine, Keren Osman

Research output: Contribution to journalArticlepeer-review

Abstract

Background aims: The acute respiratory distress syndrome (ARDS) resulting from coronavirus disease 2019 (COVID-19) is associated with a massive release of inflammatory cytokines and high mortality. Mesenchymal stromal cells (MSCs) have anti-inflammatory properties and have shown activity in treating acute lung injury. Here the authors report a case series of 11 patients with COVID-19-associated ARDS (CARDS) requiring mechanical ventilation who were treated with remestemcel-L, an allogeneic MSC product, under individual patient emergency investigational new drug applications. Methods: Patients were eligible if they were mechanically ventilated for less than 72 h prior to the first infusion. Patients with pre-existing lung disease requiring supplemental oxygen or severe liver or kidney injury were excluded. Each patient received two infusions of remestemcel-L at a dose of 2 million cells/kg per infusion given 48–120 h apart. Results: Remestemcel-L infusions were well tolerated in all 11 patients. At the end of the 28-day follow-up period, 10 (91%, 95% confidence interval [CI], 59–100%) patients were extubated, nine (82%, 95% CI, 48–97%) patients remained liberated from mechanical ventilation and were discharged from the intensive care unit and two (18%, 95 CI%, 2–52%) patients died. The median time to extubation was 10 days. Eight (73%, 95% CI, 34–100%) patients were discharged from the hospital. C-reactive protein levels significantly declined within 5 days of MSC infusion. Conclusions: The authors demonstrate in this case series that remestemcel-L infusions to treat moderate to severe CARDS were safe and well tolerated and resulted in improved clinical outcomes.

Original languageEnglish
Pages (from-to)835-840
Number of pages6
JournalCytotherapy
Volume24
Issue number8
DOIs
StatePublished - Aug 2022

Keywords

  • COVID-19
  • Remestemcel-L
  • acute respiratory distress syndrome
  • mesenchymal stromal cells

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