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Reducing mortality and morbidity in patients with severe COVID-19 disease by advancing ongoing trials of Mesenchymal Stromal (stem) Cell (MSC) therapy - Achieving global consensus and visibility for cellular host-directed therapies.

Abstract
As of May 17th 2020, the novel coronavirus disease 2019 (COVID-19) pandemic has caused 307,395 deaths worldwide, out of 3,917,366 cases reported to the World Health Organization. No specific treatments for reducing mortality or morbidity are yet available. Deaths from COVID-19 will continue to rise globally until effective and appropriate treatments and/or vaccines are found. In search of effective treatments, the global medical, scientific, pharma and funding communities have rapidly initiated over 500 COVID-19 clinical trials on a range of antiviral drug regimens and repurposed drugs in various combinations. A paradigm shift is underway from the current focus of drug development targeting the pathogen, to advancing cellular Host-Directed Therapies (HDTs) for tackling the aberrant host immune and inflammatory responses which underlie the pathogenesis of SARS-CoV-2 and high COVID-19 mortality rates. We focus this editorial specifically on the background to, and the rationale for, the use and evaluation of mesenchymal stromal (Stem) cells (MSCs) in treatment trials of patients with severe COVID-19 disease. Currently, the ClinicalTrials.gov and the WHO Clinical Trials Registry Platform (WHO ICTRP) report a combined 28 trials exploring the potential of MSCs or their products for treatment of COVID-19. MSCs should also be trialed for treatment of other circulating WHO priority Blueprint pathogens such as MERS-CoV which causes upto 34% mortality rates. It's about time funding agencies invested more into development MSCs per se, and also for a range of other HDTs, in combination with other therapeutic interventions. MSC therapy could turn out to be an important contribution to bringing an end to the high COVID-19 death rates and preventing long-term functional disability in those who survive disease.
AuthorsAlimuddin Zumla, Fu-Sheng Wang, Giuseppe Ippolito, Nicola Petrosillo, Chiara Agrati, Esam I Azhar, Chao Chang, Sherif A El-Kafrawy, Mohamed Osman, Laurence Zitvogel, Peter R Galle, Franco Locatelli, Ellen Gorman, Carlos Cordon-Cardo, Cecilia O'Kane, Danny McAuley, Markus Maeurer
JournalInternational journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases (Int J Infect Dis) Vol. 96 Pg. 431-439 (Jul 2020) ISSN: 1878-3511 [Electronic] Canada
PMID32425638 (Publication Type: Editorial)
CopyrightCopyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
Topics
  • Betacoronavirus
  • COVID-19
  • Clinical Trials as Topic
  • Consensus
  • Coronavirus Infections (immunology, mortality, pathology, therapy)
  • Humans
  • Mesenchymal Stem Cell Transplantation
  • Morbidity
  • Pandemics
  • Pneumonia, Viral (immunology, mortality, pathology, therapy)
  • SARS-CoV-2

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