By:

Louis A. Cona, MD

Reviewed:

Robert J. Hancock

Mesenchymal stem cell therapy appears to serve as an alternative candidate for ameliorating inflammation, repairing lung tissue injury, and preventing long-term pulmonary disability in patients with COVID-19.

Post-acute COVID-19 syndrome explained. (Long-Haul COVID-19)

Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long term complications beyond 4 weeks from the onset of symptoms.

Research suggests that 50 to 80 percent (1) of people who recover from COVID-19 experience at least some lingering after-effects 3 months after infection with the coronavirus. Prolonged symptom duration and disability are common in adults hospitalized with a severe form of COVID-19. Patient interviews show that while 65 percent of people who had been released from the hospital after being treated for a severe form of COVID-19 had returned to full health, 35 percent still had not fully recovered more than 2 weeks after being hospitalized.

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Long-Haul COVID-19 Symptoms

‍• fatigue
• body aches
• shortness of breath
• difficulty concentrating
• headache
• loss of taste or smell

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Breathing Issues after COVID-19

A severe case of COVID-19 can produce scarring and other permanent problems in the lungs, but even mild infections can cause long lasting shortness of breath —  after even light exertion. Lung recovery after COVID-19 is certainly possible, but can take an extended period of time. Studies are now showing that it can take months for lung function to return to pre-COVID-19 levels. (2)

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Heart Problems in COVID Long Haulers

According to Cardiologist Erin Michos, M.D., M.H.S, SARS-CoV-2 infection can leave some people with heart problems, including inflammation of the heart muscle. (3) One recent study found that 60% of people who recovered from COVID-19 still had signs of recurring inflammation of the heart, which could lead to the common symptoms such as palpitations, shortness of breath, and a rapid heartbeat. This inflammatory response was even seen in patients whom had no preexisting comorbidities or were healthy inviduals.

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Neurologic Problems in Long COVID

Some neurologists believe that Long COVIS-19 can cause long lasting neurological issues. “Some individuals develop medium to long-term symptoms following COVID infection, including brain fog, fatigue, headaches and dizziness.  The cause of these symptoms is unclear but is an active area of investigation.” A study conducted by Johns Hopkins found that these problems were common among a large sample of patients who were diagnosed with COVID-19. (4). Cognitive impairment after acute coronavirus infection can have a severe impact on a person’s life. Long-haul COVID patients may experience changes in the way they think, concentrate, speak and remember, and these symptoms can affect their ability to work or even maintain activities of daily living.

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Mesenchymal Stem Cell Therapy for COVID-19

Since the COVID-19 pandemic began there have been many studies conducted that aim to determine safety and explore efficacy of umbilical cord mesenchymal stem cell (UC‐MSC) infusions in subjects with COVID‐19. Mesenchymal stem cells administered intravenously may be able to significantly reduce significant adverse reactions, mortality, and time to recovery, in COVID-19 patients.

Mesenchymal Stem Cells (MSCs) have been shown to reduce the infiltration of macrophages, neutrophils, and DCs into the lungs and to decrease the levels of MIP-2, TNF-α, IL-6, IL-1β, and IL-12p70 in bronchoalveolar lavage fluid. Additionally, MSC-derived extracellular vesicles could also participate in immunoregulation by decreasing the absolute count of neutrophils and TNF Alpha levels in an ex vivo lung injury model and by transferring functional mitochondria to macrophages to reduce pro-inflammatory cytokine production and increase their phagocytic capacity.

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A schematic overview of the pathological characteristics and potential of MSCs for treating COVID-19.  During the acute phase, SARS-CoV-2 infection induces an inflammatory hyper-response and pulmonary tissue damage, which may lead to the partial fibrosis of lung tissues. Immunomodulatory effects of MSCs contribute to reducing inflammation.  MSCs promote proliferation of alveolar epithelial cells and vascular endothelial cells and reduce their apoptosis.  MSCs contribute to decreasing collagen deposition and inhibiting epithelial–mesenchymal transformation. (5)

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Treatment goals

The therapeutic uses of stem cells as a potential therapy for a variety of diseases has been immensely explored, the number of clinical trials conducted with Mesenchymal Stem Cells has increased exponentially over the past few years. The stated primary goal of our protocol is the marked reduction in the levels of chronic low-grade inflammation for an extended period of time.

CT images of the lungs also showed notable improvements in pulmonary lesions, including a decrease in pathological lobes, ground-glass opacity, and consolidations. Other studies have shown that MSC add-on therapy enhanced the survival of severe/critical patients and even those who developed ARDS. (5)

Stem cells have a unique, intrinsic property that attracts them to inflammation in the body. Studies have shown that stem cells can regenerate damaged or diseased tissues, reduce inflammation and modulate the immune system promoting better health and quality of life. In regards to post-acute COVID-19 syndrome, patients can expect fewer long term complications, improved recovery time, a reduction in persistent COVID-19 related symptoms & an overall decrease in inflammation throughout the body.

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References:

1) Lianna Matt McLernon | News Writer | CIDRAP News  | Jan 11, 2021. (2021, January 11). Covid-19 symptoms often linger 6 months or more, study finds. CIDRAP. Retrieved October 28, 2022, from https://www.cidrap.umn.edu/news-perspective/2021/01/covid-19-symptoms-often-linger-6-months-or-more-study-finds

2) Covid-19 Lung Damage. COVID-19 Lung Damage | Johns Hopkins Medicine. (2022, February 28). Retrieved October 28, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/what-coronavirus-does-to-the-lungs

3) Michos, E. D. (2022, February 14). Can coronavirus cause heart damage? Can Coronavirus Cause Heart Damage? | Johns Hopkins Medicine. Retrieved October 28, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/can-coronavirus-cause-heart-damage

4) Vannorsdall, T. D., Brigham, E., Fawzy, A., Raju, S., Gorgone, A., Pletnikova, A., Lyketsos, C. G., Parker, A. M., & Oh, E. S. (2021, November 15). Cognitive dysfunction, psychiatric distress, and functional decline after COVID-19. Journal of the Academy of Consultation-Liaison Psychiatry. Retrieved October 28, 2022, from https://www.sciencedirect.com/science/article/pii/S2667296021001853

5) Xu, R., Feng, Z., & Wang, F.-S. (2022, March 9). Mesenchymal stem cell treatment for covid-19. eBioMedicine. Retrieved October 28, 2022, from https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(22)00104-9/fulltext