Efficacy and Safety of MSC Cell Therapies for Hospitalized Patients with COVID-19: A Systematic Review and Meta-Analysis.

MSC (a.k.a. mesenchymal stem cell or medicinal signaling cell) cell therapies show promise in decreasing mortality in acute respiratory distress syndrome (ARDS) and suggest benefits in treatment of COVID-19-related ARDS. We performed a meta-analysis of published trials assessing the efficacy and adverse events (AE) rates of MSC cell therapy in individuals hospitalized for COVID-19. Systematic searches were performed in multiple databases through November 3, 2021. Reports in all languages, including randomized clinical trials (RCTs), non-randomized interventional trials, and uncontrolled trials, were included. Random effects model was used to pool outcomes from RCTs and non-randomized interventional trials. Outcome measures included all-cause mortality, serious adverse events (SAEs), AEs, pulmonary function, laboratory, and imaging findings. A total of 736 patients were identified from 34 studies, which included 5 RCTs (n = 235), 7 non-randomized interventional trials (n = 370), and 22 uncontrolled comparative trials (n = 131). Patients aged on average 59.4 years and 32.2% were women. When compared with the control group, MSC cell therapy was associated with a reduction in all-cause mortality (RR = 0.54, 95% CI: 0.35-0.85, I  2 = 0.0%), reduction in SAEs (IRR = 0.36, 95% CI: 0.14-0.90, I  2 = 0.0%) and no significant difference in AE rate. A sub-group with pulmonary function studies suggested improvement in patients receiving MSC. These findings support the potential for MSC cell therapy to decrease all-cause mortality, reduce SAEs, and improve pulmonary function compared with conventional care. Large-scale double-blinded, well-powered RCTs should be conducted to further explore these results.

Cell-based therapy to reduce mortality from COVID-19: Systematic review and meta-analysis of human studies on acute respiratory distress syndrome.

Severe cases of COVID-19 infection, often leading to death, have been associated with variants of acute respiratory distress syndrome (ARDS). Cell therapy with mesenchymal stromal cells (MSCs) is a potential treatment for COVID-19 ARDS based on preclinical and clinical studies supporting the concept that MSCs modulate the inflammatory and remodeling processes and restore alveolo-capillary barriers. The authors performed a systematic literature review and random-effects meta-analysis to determine the potential value of MSC therapy for treating COVID-19-infected patients with ARDS. Publications in all languages from 1990 to March 31, 2020 were reviewed, yielding 2691 studies, of which nine were included. MSCs were intravenously or intratracheally administered in 117 participants, who were followed for 14 days to 5 years. All MSCs were allogeneic from bone marrow, umbilical cord, menstrual blood, adipose tissue, or unreported sources. Combined mortality showed a favorable trend but did not reach statistical significance. No related serious adverse events were reported and mild adverse events resolved spontaneously. A trend was found of improved radiographic findings, pulmonary function (lung compliance, tidal volumes, PaO2 /FiO2 ratio, alveolo-capillary injury), and inflammatory biomarker levels. No comparisons were made between MSCs of different sources.

Breaking down silos: engaging students to help fix the US health care system.

PROBLEM: The field of health care is becoming a team effort as patient care becomes increasingly complex and multifaceted. Despite the need for multidisciplinary education, there persists a lack of student engagement and collaboration among health care disciplines, which presents a growing concern as students join the workforce. APPROACH: In October 2013, the Emory-Georgia Tech Healthcare Innovation Program organized a student driven symposium entitled "US Healthcare: What's Broken and How to Fix It: The Student Perspective". The symposium engaged students from multiple disciplines to work together in addressing problems associated with US health care delivery. The symposium was organized and carried out by a diverse group of student leaders from local institutions who adopted a multidisciplinary approach throughout the planning process. OUTCOMES: The innovative planning process leading up to the symposium revealed that many of the student-discipline groups lacked an understanding of one another's role in health care, and that students were interested in learning how to work together to leverage each other's profession. The symposium was widely attended and positively received by students and faculty from the Atlanta metropolitan area, and has since helped to promote interdepartmental collaboration and multidisciplinary education across institutions. NEXT STEPS: The student symposium will become an annual event and incorporate broader discipline representation, as well as a patient perspective. Proposals for additional institution-wide, multidisciplinary educational offerings are being addressed with the help of faculty and health care providers across the network. Accordingly, the implementation of student-driven symposia to engage students and stimulate institution-wide changes may be a beneficial and cost-effective means for academic health centers looking to facilitate multidisciplinary health care education.