PMID- 36964933
OWN - NLM
STAT- MEDLINE
DCOM- 20230517
LR  - 20230622
IS  - 1096-9071 (Electronic)
IS  - 0146-6615 (Linking)
VI  - 95
IP  - 4
DP  - 2023 Apr
TI  - Effect and safety of mesenchymal stem cells for patients with COVID-19: 
      Systematic review and meta-analysis with trial sequential analysis.
PG  - e28702
LID - 10.1002/jmv.28702 [doi]
AB  - The objective of this study was to assess whether mesenchymal stem cells (MSCs) 
      therapy could offer survival advantages for patients with novel coronavirus 
      disease 2019 (COVID-19). An electronic search of PubMed, Embase, Cochrane 
      Library, Web of Science, WanFang, and CNKI was performed from December 1, 2019 to 
      December 25, 2022. The primary outcome was all-cause mortality. Trial sequential 
      analysis (TSA) was conducted in this meta analysis. Besides, subgroup analysis 
      and meta-regression was performed using a random-effects model to find the 
      potential sources of heterogeneity. Seventeen randomized controlled trials (RCTs) 
      involving a total of 1073 patients with COVID-19 were included in this study. 
      Compared with the control group, patients in the MSCs groups were associated with 
      significantly reduced all-cause mortality (MSCs 18.4% vs. control 25.5%; risk 
      ratio [RR] 0.73; 95% confidence interval [CI] 0.59-0.90; p = 0.004; I(2) = 0%). For 
      all secondary outcomes, there wasn't significant improvement in the experimental 
      group versus the control group regarding symptom remission rate (53.2%, 201/378 
      vs. 46.5%, 164/353; RR 1.15; 95% CI 1.00-1.32; p = 0.05; I(2) = 43%), but the 
      pooled analysis revealed significant differences between the groups in length of 
      hospital stay (MD: -3.82, 95% CI: -5.87 to -1.77; p = 0.0003, I2 = 0%), 
      requirement of invasive mechanical ventilation (RR 0.52; 95% CI 0.33-0.82; 
      p = 0.005; I(2)  = 0%) and post-CRP level (MD: -31.61; 95% CI -46.74 to -16.49; 
      p < 0.0001). Moreover, regarding the incidence of adverse events (AEs) (RR 0.73; 
      95% CI 0.35-1.52; p = 0.39; I(2) = 44%) and serious adverse events (sAEs) (RR 0.87; 
      95% CI 0.40-1.92; p = 0.73; I(2) = 39%), no significant differences were observed 
      between MSCs and control groups. The TSA analysis showed that the result of 
      all-cause mortality might be false-positive result. Based on the pooled results 
      in this study, compared with standard treatment, MSCs therapy may reduce 
      all-cause mortality of patients with COVID-19 with no increase risk of AEs and 
      sAEs, but may not improve symptom remission rate. Further more high-quality and 
      large-sample RCTs should be performed to confirm these findings.
CI  - (c) 2023 The Authors. Journal of Medical Virology published by Wiley Periodicals 
      LLC.
FAU - Zhang, Zhijing
AU  - Zhang Z
AD  - Department of Respiratory and Critical Care Medicine, Beijing Institute of 
      Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, 
      Beijing, China.
FAU - Shao, Shuai
AU  - Shao S
AD  - Department of Respiratory and Critical Care Medicine, Beijing Institute of 
      Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, 
      Beijing, China.
FAU - Liu, Xuefeng
AU  - Liu X
AUID- ORCID: 0000-0002-9922-9627
AD  - Departments of Pathology, Urology, Radiation Oncology, The Ohio State University 
      Wexner Medical Center, Columbus, Ohio, USA.
AD  - Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio, USA.
FAU - Tong, Zhaohui
AU  - Tong Z
AUID- ORCID: 0000-0002-5341-6857
AD  - Department of Respiratory and Critical Care Medicine, Beijing Institute of 
      Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, 
      Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
PL  - United States
TA  - J Med Virol
JT  - Journal of medical virology
JID - 7705876
SB  - IM
MH  - Humans
MH  - *COVID-19/therapy
MH  - Randomized Controlled Trials as Topic
OTO - NOTNLM
OT  - COVID-19
OT  - all-cause mortality
OT  - cellular therapy
OT  - mesenchymal stem cells
OT  - systematic review and meta-analysis
OT  - ventilation
EDAT- 2023/03/26 06:00
MHDA- 2023/05/17 06:42
CRDT- 2023/03/25 15:43
PHST- 2023/03/20 00:00 [revised]
PHST- 2023/02/06 00:00 [received]
PHST- 2023/03/21 00:00 [accepted]
PHST- 2023/05/17 06:42 [medline]
PHST- 2023/03/26 06:00 [pubmed]
PHST- 2023/03/25 15:43 [entrez]
AID - 10.1002/jmv.28702 [doi]
PST - ppublish
SO  - J Med Virol. 2023 Apr;95(4):e28702. doi: 10.1002/jmv.28702.