UC-MSCs in the Treatment of Severe and Critical COVID-19 Patients

Shanghai East Hospital60 enrolled

Overview

The goal of this randomized, controlled, open-labeled interventional clinical trial is to test the efficacy and safety of umbilical cord mesenchymal stem cells (UC-MSCs) in the treatment of severe and critical COVID-19 patients. The main questions it aims to answer are: 1. The efficacy of UC-MSCs in the treatment of severe and critical COVID-19 patients. 2. The safety of UC-MSCs in the treatment of severe and critical COVID-19 patients. 3. The potential immune mechanisms of UC-MSCs in the treatment of severe and critical COVID-19 patients. Participants will receive standard therapy, Paxlovid treatment or the UC-MSCs treatment. For the standard treatment, it will be conducted according the 9th edition of Chinese guidelines for COVID-19 infection. For UC-MSCs treatment, participants will be given UC-MSCs instillation at the first and fourth day after assignment. Blood examples will be taken at indicated time for arterial blood gas analysis and other tests. And participants should also objectively report their symptoms change and other information related to the treatment as listed the research protocol.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Mesenchymal Stem Cell COVID-19 Pneumonia

Interventions

umbilical cord mesenchymal stem cellsBIOLOGICAL

Participants will receive two doses of UC-MSCs treatment, each dose will contain 1\*10\^6 cells/kg suspended in 100 ml albumin solution.

paxlovidDRUG

Participants will receive standard dose of paxlovid therapy, which contains 300mg namatevir and 100mg litonavir twice a day for a total course of 5 days.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * The age ranges from 18 to 75 (inclusive), regardless of gender. * Patients diagnosed with severe and critical COVID-19 pneumonia within one week, according to the Chinese diagnostic criteria for COVID-19 pneumonia in the Diagnosis and Treatment Plan for COVID-19 Pneumonia (Tentative Ninth Edition). * 20kg/m2≤body mass index（BMI）≤30 kg/m2. * Volunteer to participate in this clinical study and sign the written informed consent. Exclusion Criteria: * Those who are using immunosuppressive drugs or long-term immunosuppressive drugs after organ transplantation. * T lymphocyte abnormality (allogeneic may be considered, depending on clinical opinion), HIV positive. * Highly allergic or have a history of severe allergy, especially Interleukin-2 allergy. * Pregnant and lactating women. * Patients with severe autoimmune disease history; Allergies to all biological reagents in this treatment, such as Interleukin-2. * Patients with serious complications, including chronic cardiac insufficiency (NYHA cardiac function grading assessment of cardiac function grade III - IV), chronic renal insufficiency (CKD stage 3 and above); Chronic liver insufficiency (Child-Pugh score\>7); Patients with malignant tumors. * Patients with pulmonary embolism or acute coronary syndrome. * Patients with severe organ dysfunction caused by other diseases. * There are other situations that the researcher thinks are not suitable to participate in this clinical study.

Outcomes

Primary Outcomes

Oxygenation index

Oxygenation index is the artery partial pressure of oxygen divided by the concentration of inhaled oxygen.

Time frame: Change from baseline Oxygenation index (PaO2/FiO2) at 1,3,7,14,28 (or before the day of discharge if participants discharge within 28 days) days after the treatment.