Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing an ongoing pandemic of coronavirus disease 2019 (Covid-19). Effective therapies are required for the treatment of patients with severe stages of the disease. Mesenchymal stem cells (MSCs) have been evaluated in numerous clinical trials, but present challenges, such as carcinogenic risk and special storage conditions, coupled with insufficient data about their mechanism of action. The majority of unique properties of MSCs are related to their paracrine activity and especially to their exosomes. The impact of MSCs-derived exosomes (MSC-Es) on complications of Covid-19 has been investigated in several studies. MSC-Es may improve some complications of Covid-19 such as cytokine storm, acute respiratory distress syndrome (ARDS) and acute lung injury (ALI). Additionally, these exosomes can be evaluated as an applicable nano-size carrier for antiviral therapeutic agents. Herein, we consider several potential applications of MSCs and their derived exosomes in the treatment of Covid-19.