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[Evaluation of the effects of immunotherapy and mesenchymal stem cells transplantation in the treatment of critically ill coronavirus disease 2019 patients].
Yan, Yan; Jiang, Xiufeng; Ding, Difei; Huang, Jiehui.
  • Yan Y; Laboratory for Infection and Immunity, the Fifth People's Hospital of Wuxi, Wuxi 214016, Jiangsu, China.
  • Jiang X; Department of Respiratory and Critical Care Medicine, the Fifth People's Hospital of Wuxi, Wuxi 214016, Jiangsu, China. Corresponding author: Yan Yan, Email: yanyana20@163.com.
  • Ding D; Laboratory for Infection and Immunity, the Fifth People's Hospital of Wuxi, Wuxi 214016, Jiangsu, China.
  • Huang J; Department of Respiratory and Critical Care Medicine, the Fifth People's Hospital of Wuxi, Wuxi 214016, Jiangsu, China. Corresponding author: Yan Yan, Email: yanyana20@163.com.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 33(2): 139-144, 2021 Feb.
Article in Chinese | MEDLINE | ID: covidwho-1138770
Semantic information from SemMedBD (by NLM)
1. Biological Response Modifiers TREATS COVID-19
Subject
Biological Response Modifiers
Predicate
TREATS
Object
COVID-19
2. Mesenchymal Stem Cell Transplantation TREATS COVID-19
Subject
Mesenchymal Stem Cell Transplantation
Predicate
TREATS
Object
COVID-19
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Biological Response Modifiers TREATS Patients
Subject
Biological Response Modifiers
Predicate
TREATS
Object
Patients
5. Mesenchymal Stem Cell Transplantation TREATS Patients
Subject
Mesenchymal Stem Cell Transplantation
Predicate
TREATS
Object
Patients
6. Indicators INTERACTS_WITH Biological Response Modifiers
Subject
Indicators
Predicate
INTERACTS_WITH
Object
Biological Response Modifiers
7. Comorbidity PROCESS_OF Persons
Subject
Comorbidity
Predicate
PROCESS_OF
Object
Persons
8. Immunologic Adjuvants TREATS Borg Category-Ratio 10 Perceived Exertion Score 5
Subject
Immunologic Adjuvants
Predicate
TREATS
Object
Borg Category-Ratio 10 Perceived Exertion Score 5
9. Borg Category-Ratio 10 Perceived Exertion Score 5 PROCESS_OF Patients
Subject
Borg Category-Ratio 10 Perceived Exertion Score 5
Predicate
PROCESS_OF
Object
Patients
10. Interferon-alpha TREATS Confirmed case
Subject
Interferon-alpha
Predicate
TREATS
Object
Confirmed case
11. Immunologic Adjuvants TREATS Patients
Subject
Immunologic Adjuvants
Predicate
TREATS
Object
Patients
12. Interferon-alpha NEG_TREATS Critical Illness
Subject
Interferon-alpha
Predicate
NEG_TREATS
Object
Critical Illness
13. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
14. Albumins NEG_TREATS Patients
Subject
Albumins
Predicate
NEG_TREATS
Object
Patients
15. Interferon-alpha NEG_TREATS Patients
Subject
Interferon-alpha
Predicate
NEG_TREATS
Object
Patients
16. Gamma globulin NEG_TREATS Patients
Subject
Gamma globulin
Predicate
NEG_TREATS
Object
Patients
17. Lung Transplantation TREATS Pulmonary hemorrhage
Subject
Lung Transplantation
Predicate
TREATS
Object
Pulmonary hemorrhage
18. Lung Transplantation TREATS Oxygen saturation below reference range
Subject
Lung Transplantation
Predicate
TREATS
Object
Oxygen saturation below reference range
19. Blood LOCATION_OF C-reactive protein
Subject
Blood
Predicate
LOCATION_OF
Object
C-reactive protein
20. peripheral blood PART_OF Patients
Subject
peripheral blood
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PART_OF
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Patients
21. peripheral blood LOCATION_OF T-Cell Surface Glycoprotein CD
Subject
peripheral blood
Predicate
LOCATION_OF
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T-Cell Surface Glycoprotein CD
22. Nucleic Acids PART_OF 2019 novel coronavirus
Subject
Nucleic Acids
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PART_OF
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2019 novel coronavirus
23. C-reactive protein ASSOCIATED_WITH Critical Illness
Subject
C-reactive protein
Predicate
ASSOCIATED_WITH
Object
Critical Illness
24. C-reactive protein PART_OF Patients
Subject
C-reactive protein
Predicate
PART_OF
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Patients
25. IFNA1 PREVENTS Inflammation
Subject
IFNA1
Predicate
PREVENTS
Object
Inflammation
26. Gamma globulin PREVENTS Inflammation
Subject
Gamma globulin
Predicate
PREVENTS
Object
Inflammation
27. Immune Sera PREVENTS Inflammation
Subject
Immune Sera
Predicate
PREVENTS
Object
Inflammation
28. Mesenchymal Stem Cell Transplantation PREVENTS Inflammation
Subject
Mesenchymal Stem Cell Transplantation
Predicate
PREVENTS
Object
Inflammation
29. Kidney LOCATION_OF Inflammation
Subject
Kidney
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LOCATION_OF
Object
Inflammation
30. Liver LOCATION_OF Inflammation
Subject
Liver
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LOCATION_OF
Object
Inflammation
31. Mesenchymal Stem Cell Transplantation TREATS Inflammation
Subject
Mesenchymal Stem Cell Transplantation
Predicate
TREATS
Object
Inflammation
32. Biological Response Modifiers TREATS COVID-19
Subject
Biological Response Modifiers
Predicate
TREATS
Object
COVID-19
33. Mesenchymal Stem Cell Transplantation TREATS COVID-19
Subject
Mesenchymal Stem Cell Transplantation
Predicate
TREATS
Object
COVID-19
34. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
35. Biological Response Modifiers TREATS Patients
Subject
Biological Response Modifiers
Predicate
TREATS
Object
Patients
36. Mesenchymal Stem Cell Transplantation TREATS Patients
Subject
Mesenchymal Stem Cell Transplantation
Predicate
TREATS
Object
Patients
37. Indicators INTERACTS_WITH Biological Response Modifiers
Subject
Indicators
Predicate
INTERACTS_WITH
Object
Biological Response Modifiers
38. Comorbidity PROCESS_OF Persons
Subject
Comorbidity
Predicate
PROCESS_OF
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Persons
39. Immunologic Adjuvants TREATS Borg Category-Ratio 10 Perceived Exertion Score 5
Subject
Immunologic Adjuvants
Predicate
TREATS
Object
Borg Category-Ratio 10 Perceived Exertion Score 5
40. Borg Category-Ratio 10 Perceived Exertion Score 5 PROCESS_OF Patients
Subject
Borg Category-Ratio 10 Perceived Exertion Score 5
Predicate
PROCESS_OF
Object
Patients
41. Interferon-alpha TREATS Confirmed case
Subject
Interferon-alpha
Predicate
TREATS
Object
Confirmed case
42. Immunologic Adjuvants TREATS Patients
Subject
Immunologic Adjuvants
Predicate
TREATS
Object
Patients
43. Interferon-alpha NEG_TREATS Critical Illness
Subject
Interferon-alpha
Predicate
NEG_TREATS
Object
Critical Illness
44. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
45. Albumins NEG_TREATS Patients
Subject
Albumins
Predicate
NEG_TREATS
Object
Patients
46. Interferon-alpha NEG_TREATS Patients
Subject
Interferon-alpha
Predicate
NEG_TREATS
Object
Patients
47. Gamma globulin NEG_TREATS Patients
Subject
Gamma globulin
Predicate
NEG_TREATS
Object
Patients
48. Lung Transplantation TREATS Pulmonary hemorrhage
Subject
Lung Transplantation
Predicate
TREATS
Object
Pulmonary hemorrhage
49. Lung Transplantation TREATS Oxygen saturation below reference range
Subject
Lung Transplantation
Predicate
TREATS
Object
Oxygen saturation below reference range
50. Blood LOCATION_OF C-reactive protein
Subject
Blood
Predicate
LOCATION_OF
Object
C-reactive protein
51. peripheral blood PART_OF Patients
Subject
peripheral blood
Predicate
PART_OF
Object
Patients
52. peripheral blood LOCATION_OF T-Cell Surface Glycoprotein CD4, human|CD4
Subject
peripheral blood
Predicate
LOCATION_OF
Object
T-Cell Surface Glycoprotein CD4, human|CD4
53. Nucleic Acids PART_OF 2019 novel coronavirus
Subject
Nucleic Acids
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PART_OF
Object
2019 novel coronavirus
54. C-reactive protein ASSOCIATED_WITH Critical Illness
Subject
C-reactive protein
Predicate
ASSOCIATED_WITH
Object
Critical Illness
55. C-reactive protein PART_OF Patients
Subject
C-reactive protein
Predicate
PART_OF
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Patients
56. IFNA1 PREVENTS Inflammation
Subject
IFNA1
Predicate
PREVENTS
Object
Inflammation
57. Gamma globulin PREVENTS Inflammation
Subject
Gamma globulin
Predicate
PREVENTS
Object
Inflammation
58. Immune Sera PREVENTS Inflammation
Subject
Immune Sera
Predicate
PREVENTS
Object
Inflammation
59. Mesenchymal Stem Cell Transplantation PREVENTS Inflammation
Subject
Mesenchymal Stem Cell Transplantation
Predicate
PREVENTS
Object
Inflammation
60. Kidney LOCATION_OF Inflammation
Subject
Kidney
Predicate
LOCATION_OF
Object
Inflammation
61. Liver LOCATION_OF Inflammation
Subject
Liver
Predicate
LOCATION_OF
Object
Inflammation
62. Mesenchymal Stem Cell Transplantation TREATS Inflammation
Subject
Mesenchymal Stem Cell Transplantation
Predicate
TREATS
Object
Inflammation
ABSTRACT

OBJECTIVE:

To analyze the immunotherapy and clinical characteristics of coronavirus disease 2019 (COVID-19) patients, and focus on exploring the effects of immunotherapy and mesenchymal stem cells (MSC) transplantation in the critically ill patients' treatment.

METHODS:

Fity-five COVID-19 patients were admitted to the Fifth People's Hospital of Wuxi from January 23rd to March 31st, 2020 as the research object. The demographic characteristics of the cases and the methods of immunotherapy were analyzed, focusing on the immunized indicators, positivity of pathogens and clinical indicators of critically ill COVID-19 patient, and the effects of immunotherapy and stem cell transplantation were evaluated.

RESULTS:

Aged, male and people with comorbidities were the main risk factors in the development of severe and critical COVID-19. All of confirmed COVID-19 cases (n = 55) had been treated with interferon-α (IFN-α), of which 81.8% (n = 45, mild and ordinary) of the patients were recovered, 14.6% (n = 8) of the patients were converted to severe, 3.6% (n = 2) of the patients were converted to critical, and some severe patients were treated with gamma globulin and albumin as adjuvant treatment. Critically ill patients were not only treated with IFN-α, gamma globulin and albumin, but also treated with convalescent plasma and MSC transplantation. Due to pulmonary hemorrhage and persistently low blood oxygen saturation, terminal lung transplantation therapy was implemented. The total number of lymphocytes, CD4+, CD8+ T lymphocytes, natural killer (NK) cells and B cells in peripheral blood of the two critical COVID-19 patients were significantly reduced, and the functions of lung, liver, and kidney were severely damaged on admission, manifested as significant increase of the levels of blood C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and blood urea nitrogen (BUN), etc. and decrease of blood oxygen saturation, and type I respiratory failure, and the noninvasive assisted ventilation was needed to improve. After adjuvant immunotherapy such as gamma globulin, the nucleic acid of 2019 novel coronavirus (2019-nCoV) turned into negative. The CRP of one critically ill patient was significantly lower than the value at admission (minimum of 21 mg/L). But the lung inflammation progressed rapidly, and the pathological results of the lung tissue from the lung transplantation showed hemorrhage and irreversible fibrosis. The ability to secrete immunoglobulin A (IgA) was significantly reduced. Liver function had been significantly improved and stabilized after treatment with convalescent plasma during the recovery period. MSC transplantation treatment reduced the BUN level by > 50% compared with the previous period, and the total number of lymphocytes in the patient increased by more than 2 times (rose from 0.23×109/L to 0.57×109/L), but the total amount of lymphocytes was still lower than the normal reference value (< 1.1×109/L). The lung inflammation lesions were obviously absorbed, and the vital signs were stable.

CONCLUSIONS:

In addition to IFN, gamma globulin, antiserum and MSC transplantation therapy can help clear the virus and reduce inflammation. Although MSC transplantation fail to completely change the immunecompromised state of critically ill patients, it controlled the progression of inflammation in the liver and kidneys.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Mesenchymal Stem Cells / COVID-19 Type of study: Risk factors Limits: Aged / Humans / Male Language: Chinese Journal: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue Year: 2021 Document Type: Article Affiliation country: Cma.j.cn121430-20201113-00714

Full text: Available Collection: International databases Database: MEDLINE Main subject: Mesenchymal Stem Cells / COVID-19 Type of study: Risk factors Limits: Aged / Humans / Male Language: Chinese Journal: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue Year: 2021 Document Type: Article Affiliation country: Cma.j.cn121430-20201113-00714