This is a phase 1/2a study including 2 parts, phase 1 and phase 2a. The phase 1 part is an open-label, single-arm, dose-escalating study to evaluate the safety and explore the dose limiting toxicity and maximum tolerated dose of a human umbilical cord derived mesenchymal stem cell product (BX-U001) in severe COVID-19 pneumonia patients with acute respiratory distress syndrome (ARDS). Qualified subjects after the screening will be divided into low, medium, or high dose groups to receive a single intravenous infusion of BX-U001 at the dose of 0.5×10\^6, 1.0×10\^6, or 1.5×10\^6 cells/kg of body weight, respectively. The Phase 2a part is a randomized, placebo-controlled, double-blind clinical trial examining the safety and biological effects of BX-U001 at the appropriate dose selected from phase 1 for severe COVID-19 pneumonia patients with the same inclusion/exclusion criteria as the phase 1 part.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
hUC-MSC product will be administered intravenously in addition to the standard of care treatment.
Placebo control will be administered intravenously in addition to the standard of care treatment.
Incidence of infusion-related adverse events
Safety will be defined by the incidence of infusion-related adverse events as assessed by the treating physician
Time frame: Day 3
Incidence of any treatment-emergent adverse events (TEAEs) and treatment emergent serious adverse events (TESAEs)
Safety will be defined by the incidence of TEAEs and TESAEs as assessed by the treating physician
Time frame: Day 28
Selection of an appropriate dose of BX-U001 for the following Phase 2 study
The dose will be selected based on the assessment of dose-limiting toxicity and maximum tolerated dose.
Time frame: Day 28
All-cause mortality
Time frame: Day 28
Proportion of patients achieving clinical response by the improvement of at least 2 points on the 7-point ordinal scale.
The scale is as follows: 1. Death 2. Hospitalized, on invasive mechanical ventilation or extracorporeal membrane oxygenation (ECMO) 3. Hospitalized, on non-invasive ventilation or high flow oxygen devices 4. Hospitalized, requiring low flow supplemental oxygen 5. Hospitalized, not requiring supplemental oxygen - requiring ongoing medical care (COVID-19 related or otherwise) 6. Hospitalized, not requiring supplemental oxygen - no longer required ongoing medical care 7. Not hospitalized.
Time frame: Day 14
Duration of ICU stay
Time frame: Day 28
Duration of hospital stay
Time frame: Day 28
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Changes in blood cytokine levels
Time frame: Day 28