Case series of the first three severe COVID-19 patients treated with the secretome of hypoxia-mesenchymal stem cells in Indonesia [version 3; peer review: 2 approved]

• Published in: F1000 research 2021, Vol.10, p.228
• Main Authors: Putra, Agung, Widyatmoko, Agus, Ibrahim, Sugeng, Amansyah, Fajar, Amansyah, Farid, Berlian, Mukti Arja, Retnaningsih, Retnaningsih, Pasongka, Zenitalia, Sari, Flora Eka, Rachmad, Basuki
• Format: Article
• Language: English
• Subjects: Clinical Practice; COVID-19; eng; mesenchymal stem cells; secretome
• ISSN: 2046-1402; 2046-1402
• DOI: 10.12688/f1000research.51191.3

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the outbreak of coronavirus disease 2019 (COVID-19), which has been rapidly spreading. Several guideline therapies have been proposed as a possible treatment for SARS-CoV-2, however, these therapies are not sufficient to treat a severe condition of SARS-CoV-2 infection characterised by the increase of D-dimer and C-reactive protein (CRP) levels, and patchy ground-glass opacities (GGOs). Secretome-mesenchymal stem cells (S-MSCs) produced by MSCs under hypoxia could excessively release several anti-inflammatory cytokines and growth factors to control the COVID-19 cytokine storm and accelerate lung injury improvement. This is the first study investigating the clinical outcomes of three severe COVID-19 patients admitted to the intensive care unit of three different hospitals in Indonesia treated with S-MSCs. The decrease of D-dimer and CRP level was reported for all patients treated with S-MSCs. This was in line with improvement of pulmonary radiology, blood gas level, and hematologic assessment. In conclusion, these cases suggest that S-MSCs could effectively control D-dimer, CRP level and GGOs of severe COVID-19 patients associated with recovered pulmonary function.