Safety and efficacy of autologous non-hematopoietic enriched stem cell nebulization in COVID-19 patients: a randomized clinical trial, Abu Dhabi 2020.
Background
The novel SARS-CoV-2 has caused the coronavirus disease 2019 (COVID-19) pandemic. Currently, with insufficient worldwide vaccination rates, identifying treatment solutions to reduce the impact of the virus is urgently needed.


Method
An adaptive, multicentric, open-label, and randomized controlled phase I/II clinical trial entitled the "SENTAD-COVID Study" was conducted by the Abu Dhabi Stem Cells Center under exceptional conditional approval by the Emirates Institutional Review Board (IRB) for COVID-19 Research Committee from April 4th to July 31st, 2020, using an autologous peripheral blood non-hematopoietic enriched stem cell cocktail (PB-NHESC-C) administered by compressor (jet) nebulization as a complement to standard care therapy. The primary endpoints include safety and efficacy assessments, adverse events, the mortality rate within 28 days, and the time to clinical improvement as measured by a 2-point reduction on a seven-category ordinal scale or discharge from the hospital whichever occurred first.


Results
The study included a total of 139 randomized COVID-19 patients, with 69 in the experimental group and 70 in the control group (standard care). Overall survival was 94.20% for the cocktail-treated group vs. 90.27% for the control group. Adverse events were reported in 50 (72.46%) patients receiving PB-NHESC-C and 51 (72.85%) in the control group (p = 0.9590), with signs and symptoms commonly found in COVID-19. After the first 9 days of the intervention, 67.3% of cocktail-treated patients recovered and were released from hospitals compared to 53.1% (RR = 0.84; 95% CI, 0.56-1.28) in the control group. Improvement, i.e., at least a 2-point reduction in the severity scale, was more frequently observed in cocktail-treated patients (42.0%) than in controls (17.0%) (RR = 0.69; 95% CI, 0.56-0.88).


Conclusions
Cocktail treatment improved clinical outcomes without increasing adverse events. Thus, the nebulization of PB-NHESC-C was safe and effective for treatment in most of these patients.


Trial registration
ClinicalTrials.gov. NCT04473170. It was retrospectively registered on July 16th, 2020.
['Ventura-Carmenate|Yendry|Y|', 'Alkaabi|Fatima Mohammed|FM|', 'Castillo-Aleman|Yandy Marx|YM|', 'Villegas-Valverde|Carlos Agustin|CA|', 'Ahmed|Yasmine Maher|YM|', 'Sanna|Pierdanilo|P|', 'Almarzooqi|Ayesha Abdulla|AA|', 'Abdelrazik|Abeer|A|', 'Torres-Zambrano|Gina Marcela|GM|', 'Wade-Mateo|Maura|M|', 'Quesada-Saliba|David|D|', 'Abdel Hadi|Loubna|L|', 'Bencomo-Hernandez|Antonio Alfonso|AA|', 'Rivero-Jimenez|Rene Antonio|RA|']
Stem cells COVID-19 Immunomodulation Nebulizers and vaporizers Recovery of function