Systemic administration of human umbilical cord‑derived mesenchymal stem cells effectively ameliorates the outcomes of a critically ill elderly patient with COVID‑19 with multiple comorbidities: A case report

The outbreak of coronavirus disease 2019 (COVID‐19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has spread worldwide and has become a public health emergency, principally due to the severe inflammatory response and cytokine storm, as well as the deficiency of specific vaccines and antiviral drugs. Despite the fact that mesenchymal stem cells (MSCs) are acknowl‐ edged to possess unique immunomodulatory capabilities and have promising prospects in regenerative medicine, the effi‐ cacy of the use of MSCs on critically ill elderly patients with COVID‐19 is largely obscure. In the present study, a 75‐year‐old male patient critically ill with COVID‐19 was enrolled with multiple concomitant diseases, including hypertension (for >10 years), diabetes and coronary heart disease (for >1 year). Systemic infusions of 5x107 human umbilical cord‐derived mesenchymal stem/stromal cells (hUC‐MSCs) were accom‐ plished through intravenous injection every 3 days for 3 times following the consents of the patient and the relevant ethics committee. The clinical and functional outcomes, including general symptoms, vital signs, hemogram, chest radiography and the disease score, together with inflammatory factors and SARS‐CoV‐2 nucleic acid detection, were observed and dynamically recorded for 1 month. With the aid of hUC‐MSC administration, the severe COVID‐19‐associated symptoms of the elderly patient, and in particular, pneumonia and the cytokine storm were continuously ameliorated. Moreover, the outcomes of multiple concomitant diseases were improved, whereas no deterioration and secondary infections, such as fever and allergic reaction were observed. The present study thus indicated that hUC‐MSC administration can amelio‐ rate the outcomes of patients with COVID‐19. This type of treatment may prove to be an ideal alternative option for the treatment of patients with COVID‐19, even for critically ill elderly patients with multisystemic complications. Systemic administration of human umbilical cord‐derived mesenchymal stem cells effectively ameliorates the outcomes of a critically ill elderly patient with COVID‐19 with multiple comorbidities: A case report HONGJUN CHEN1*, LEISHENG ZHANG2‐4*, ZHIXU HE5*, DALI WANG6, LILI LIU7, WEI ZHANG1, TAO CHEN1, ZHIHUA DAI8, ZHONGCHAO HAN2,3 and MIAO CHEN1 1Department of Intensive Care Unit, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003; 2Jiangxi Research Center of Stem Cell Engineering, Jiangxi Health‐Biotech Stem Cell Technology Co., Ltd., Shangrao, Jiangxi 334000; 3Division of Precision Medicine, Health‐Biotech (Tianjin) Stem Cell Research Institute Co., Ltd., Tianjin 301700; 4School of Medicine, Nankai University, Tianjin 300071; 5Department of Pediatrics, Zunyi Medical University, Zunyi, Guizhou 563006; Departments of 6Burn and Plastic Surgery, and 7Cerebrovascular Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563003; 8Stem Cell Bank of Guizhou Province, Guizhou Health‐Biotech Biotechnology Co., Ltd., Guiyang, Guizhou 550000, P.R. China Received July 22, 2020; Accepted September 28, 2020 DOI: 10.3892/wasj.2020. 70 Correspondence to: Professor Zhongchao Han, Jiangxi Research Center of Stem Cell Engineering, Jiangxi Health‐Biotech Stem Cell Technology Co., Ltd., 001 Lanjiang Road, Shangrao, Jiangxi 334000, P.R. China E‐mail: hanzhongchao@health‐biotech.com Professor Miao Chen, Department of Intensive Care Unit, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Zunyi, Guizhou 563003, P.R. China E‐mail: 764590955@qq.com *Contributed equally Abbreviations: hUC‐MSCs, human umbilical cord‐derived mesenchymal stem/stromal cells; SARS‐CoV‐2, severe acute respiratory syndrome coronavirus 2; COVID‐19, coronavirus disease 2019; ARDS, acute respiratory distress syndrome; NHC, National Health Commission; ACE2, angiotensin I converting enzyme 2 receptor; MERS‐CoV, Middle East respiratory syndrome coronavirus; APACHE II, acute physiology and chronic health evaluation II; SOFA, sequential organ failure assessment; PSI, pneumonia severity index; MODS, multiple organ dysfunction syndrome; WBCs, white blood cells; OT, oxygen treatment; OI, oxygenation index; BNP, brain natriuretic peptide; TNT, troponin T; SCR, serum creatinine; P, pulse; R, respiration; BUN, blood urea nitrogen; SpO2, oxygen saturation; FiO2, fraction of inspired O2; ICU, intensive care unit; NIV, non‐invasive ventilator‐assisted breathing; RT‐qPCR, reverse transcription‐quantitative polymerase chain reaction