Safety and Efficacy of Autologous Non-Hematopoietic Enriched Stem Cell Nebulization in Covid-19 Patients. A Randomized Clinical Trial, Abu Dhabi 2020.

Abstract Background: The novel SARS-Cov-2 has caused the COVID-19 pandemic. Currently, with insufficient worldwide vaccination rates, the identification of 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 conditional exceptional approval by the Emirates Institutional Review Board (IRB) for COVID-19 Research Committee from April 4 to July 31, 2020, using an autologous peripheral blood nonhematopoietic 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 occurred in 43 (62.32%) patients receiving PB-NHESC-C vs. 44 (62.86%) in the control group, and most adverse events were related to the disease. After the first nine 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. Registered 16 July 2020. Retrospectively registered. https://clinicaltrials.gov/ct2/show/NCT04473170.