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Background <p>The long-term effects and outcomes of human mesenchymal stem cell (MSC) therapy in patients with severe coronavirus disease 2019 (COVID-19) remain poorly understood. This study aimed to evaluate the extended safety and efficacy of MSC treatment in severe patients with COVID-19 who participated in our earlier randomized, double-blind, placebo-controlled clinical trial, with follow-up conducted over 3&#xa0;years.</p> Methods <p>One hundred patients with severe COVID-19 were randomized to receive either an MSC infusion (n = 65, 4 × 10<sup>7</sup> cells/dose, on days 0, 3, and 6) or a placebo, with both groups receiving the standard of care. At 36&#xa0;months post-MSC therapy, patients were followed up to long-term safety and efficacy, particularly the effects of MSC therapy on persistent COVID-19 symptoms. Evaluated outcomes included lung imaging results, 6-min walking distance (6-MWD), pulmonary function test results, quality of life scores based on the Short Form-36 (SF-36) health survey, Long COVID symptoms, new-onset comorbidities, tumor marker levels, and rates of COVID-19 reinfection.</p> Results <p>Three years post-treatment, 46.94% (23/49) of patients in the MSC group and 34.48% (10/29) in the placebo group showed normal findings on computed tomography (CT) images (odds ratio [OR] = 1.68, 95% confidence interval [CI]: 0.65–4.34). The general health (GH) score from the SF-36 was higher in the MSC group (67.0) compared to the placebo group (50.0), with a difference of 12.86 (95% CI: 1.44–24.28). Both groups showed similar results for total lung severity scores (TSS), 6-MWD, pulmonary function tests, and Long COVID symptoms. No significant differences between groups were observed in new-onset complications (including tumorigenesis) or tumor marker levels. After adjusting for China’s dynamic zero-COVID-19 strategy, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection rates were 53.06% (26/49) in the MSC group&#xa0;and 67.86% (19/28) in the placebo group (OR = 0.54, 95% CI: 0.20–1.41).</p> Conclusions <p>These findings support the long-term safety of MSC therapy in patients with severe COVID-19 over 3&#xa0;years. MSC treatment may offer potential benefits for lung recovery and improved quality of life in patients experiencing Long COVID symptoms.</p> <p><i>Trial registration</i><b>:</b> ClinicalTrials.gov, NCT04288102. Registered 28 February 2020, <a href="https://clinicaltrials.gov/study/NCT04288102">https://clinicaltrials.gov/study/NCT04288102</a>.</p>

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Long-term outcomes of mesenchymal stem cell therapy in severe COVID-19 patients: 3-year follow-up of a randomized, double-blind, placebo-controlled trial

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月25日

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  • Meng-Qi Yuan,
  • Le Song,
  • Ze-Rui Wang,
  • Zi-Ying Zhang,
  • Ming Shi,
  • Junli He,
  • Qiong Mo,
  • Ning Zheng,
  • Wei-Qi Yao,
  • Yu Zhang,
  • Tengyun Dong,
  • Yuanyuan Li,
  • Chao Zhang,
  • Jinwen Song,
  • Lei Huang,
  • Zhe Xu,
  • Xin Yuan,
  • Jun-Liang Fu,
  • Cheng Zhen,
  • Jianming Cai,
  • Jinghui Dong,
  • Jianzeng Zhang,
  • Wei-Fen Xie,
  • Yonggang Li,
  • Bo Zhang,
  • Lei Shi,
  • Fu-Sheng Wang

摘要

Background

The long-term effects and outcomes of human mesenchymal stem cell (MSC) therapy in patients with severe coronavirus disease 2019 (COVID-19) remain poorly understood. This study aimed to evaluate the extended safety and efficacy of MSC treatment in severe patients with COVID-19 who participated in our earlier randomized, double-blind, placebo-controlled clinical trial, with follow-up conducted over 3 years.

Methods

One hundred patients with severe COVID-19 were randomized to receive either an MSC infusion (n = 65, 4 × 107 cells/dose, on days 0, 3, and 6) or a placebo, with both groups receiving the standard of care. At 36 months post-MSC therapy, patients were followed up to long-term safety and efficacy, particularly the effects of MSC therapy on persistent COVID-19 symptoms. Evaluated outcomes included lung imaging results, 6-min walking distance (6-MWD), pulmonary function test results, quality of life scores based on the Short Form-36 (SF-36) health survey, Long COVID symptoms, new-onset comorbidities, tumor marker levels, and rates of COVID-19 reinfection.

Results

Three years post-treatment, 46.94% (23/49) of patients in the MSC group and 34.48% (10/29) in the placebo group showed normal findings on computed tomography (CT) images (odds ratio [OR] = 1.68, 95% confidence interval [CI]: 0.65–4.34). The general health (GH) score from the SF-36 was higher in the MSC group (67.0) compared to the placebo group (50.0), with a difference of 12.86 (95% CI: 1.44–24.28). Both groups showed similar results for total lung severity scores (TSS), 6-MWD, pulmonary function tests, and Long COVID symptoms. No significant differences between groups were observed in new-onset complications (including tumorigenesis) or tumor marker levels. After adjusting for China’s dynamic zero-COVID-19 strategy, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection rates were 53.06% (26/49) in the MSC group and 67.86% (19/28) in the placebo group (OR = 0.54, 95% CI: 0.20–1.41).

Conclusions

These findings support the long-term safety of MSC therapy in patients with severe COVID-19 over 3 years. MSC treatment may offer potential benefits for lung recovery and improved quality of life in patients experiencing Long COVID symptoms.

Trial registration: ClinicalTrials.gov, NCT04288102. Registered 28 February 2020, https://clinicaltrials.gov/study/NCT04288102.