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]
Basuki Rachmad,
Flora Eka Sari,
Fajar Amansyah,
Sugeng Ibrahim,
Agus Widyatmoko,
Agung Putra,
Zenitalia Pasongka,
Retnaningsih Retnaningsih,
Mukti Arja Berlian,
Farid Amansyah
Affiliations
Basuki Rachmad
Department of Intensive Care Unit, Gatot Soebroto Army Hospital, Jakarta, Jakarta, Indonesia
Flora Eka Sari
Department of Pulmonary Medicine, Dr. Esnawan Antariksa Air Force Hospital, Jakarta, Jakarta, Indonesia
Fajar Amansyah
Department of Internal Medicine, Bhayangkara Hospital, Makassar, South Sulawesi, Indonesia
Sugeng Ibrahim
Stem Cell and Cancer Research (SCCR), Faculty of Medicine, Universitas Islam Sultan Agung (Unissula), Semarang, Central Java, Indonesia
Agus Widyatmoko
Department of Internal Medicine, Faculty of Medicine, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Yogyakarta, Indonesia
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.
