Table 1: The clinical trials of MSCs on COVID-19.

Identifier

Phase

Status

Location

Cell Type

Estimated Enrollment

Doses and Route of Administration

Primary Outcome Measure

NCT04252118

1

Recruiting

China

Allogeneic UC-MSC

20

Three doses of 3.0 × 107 at days 0, 3, 6

Size of lesion area by chest radiograph or CT, Side effects in MSC treatment group

NCT04276987

1

Completed

China

Allogeneic adipose MSC-exos

30

Five doses of 2.0 × 108 nanovesicles, days 1, 2, 3, 4, and 5, aerosol inhalation route

Adverse and severe adverse reaction, Time to clinical improvement

NCT04299152

2

Not yet recruiting

China

CB-MSC

20

N/A

Number of patients unable to complete SCE therapy

NCT04273646

N/A

Not yet recruiting

China

Allogeneic UC-MSC

48

Four doses of 5.0 × 106 cells/kg at, days 1, 3, 5, and 7, IV+ conventional treatment

Pneumonia severity index, Oxygenation index

NCT04288102

1-2

Completed

China

Allogeneic UC-MSC

90 (Placebo:30)

Three doses of 4 × 107, at days 0, 3, 6, IV + standard of care

Size of lesion area and severity of pulmonary fibrosis by CT

NCT04302519

1

Not yet recruiting

Shanghai

Dental pulp MSC

24

Three doses of 1.0 × 106 cells/kg, at days 1, 3, and 7, IV

Disappear time of ground-glass shadow in the lungs

NCT04313322

1

Recruiting

Jordan

Allogeneic WJ-MSC

5

Three doses of 1 × 106/kg, 3 days apart, IV

Clinical outcome, CT scan, RT-PCR results

NCT04293692

N/A

Withdrawn

China

UC-MSC

N/A

Study was withdrawn before participants were enrolled.

Size of lesion area by chest imaging, Blood oxygen saturation

NCT04269525

2

Recruiting

China

Allogeneic UC-MSC

10

Four doses of 3.3 × 107 cells at, days 1, 3, 5, and 7, IV

Oxygenation index

NCT04457609

1

Recruiting

Indonesia

UC-MSC

40

Intravenous infusion of 1 × 106 unit of UC- MSCs/kg BW in 100 cc of 0.9% NaCl for 1 h, in addition to standardized treatment (oseltamivir and azithromycin)

Presence of dyspnea, presence of sputum, fever, ventilation status, blood pressure, heart rate, respiratory rate, oxygen saturation

NCT04461925

1-2

Recruiting

Ukraine

Allogeneic placenta MSC

30

1 million cells/kg body weight/time, once every 3 days for a total of 3 times: day “1”, day “4”, day “7”, IV + ceftriaxone, azithromycin, anticoagulants, hormones, oxygen therapy, mechanical ventilation and other supportive therapies

Changes of oxygenation index PaO2/FiO2, most conveniently the P/F ratio. Changes in length of hospital stay, Changes in mortality rate

NCT04466098

2

Not yet recruiting

N/A

MSC

30 (Placebo:15)

300 × 106 MSCs, three fixed doses of MSCs, approximately 48 h apart, IV

Incidence of grade 3-5 infusional toxicities and predefned hemodynamic or respiratory adverse events related to the infusion of MSC

NCT04416139

2

Recruiting

Mexico

UC-MSC

10

1 million/kg in a single dose, IV

Functional respiratory changes: PaO2/FiO2 ratio, Clinical cardiac changes: Heart rate per minute, Clinical respiratory changes: respiratory rate per minute, Changes in body temperature

NCT04336254

1-2

Recruiting

China

Allogeneic dental pulp MSC

20

Three doses of 3.0 × 107 cells/dose at, days 1, 4 and 7, IV

Time to clinical improvement

NCT04429763

2

Not yet recruiting

Colombia

UC-MSC

30

1 × 106 cells/kg single dose, IV

Clinical deterioration or death

NCT04456361

1

Active, not recruiting

N/A

WJ-UC-MSC

9

Single-dose of 1 × 108 cells, IV

Oxygen saturation

NCT04315987

2

Not yet recruiting

Brazil

MSC

90 (Placebo:45)

Four doses of 2 × 106/kg, at days 1, 3, 5, and 7, IV

Change in clinical condition

NCT04366063

2-3

Recruiting

Iran

MSC

60 (Placebo:20)

Intervention group 1: two doses 1 × 108 at day 0, 2, IV Intervention group 2: two doses 1 × 108 at day 0, 2 + EVs at days 4, 6, IV

Adverse events assessment, Blood oxygen saturation

NCT04437823

2

Recruiting

Pakistan

UC-MSC

20 (Placebo:5)

5 × 105 UCMSCs per kg, IV on days 1, 3 and 5 besides the standard care (SOC)

Safety and efficacy assessment of infusion associated adverse events, Chest radiograph or Chest CT scan

NCT04390152

1-2

Not yet recruiting

Colombia

Allogeneic WJ-MSC

40

Two doses of 50 × 106, IV

Intergroup mortality diference with treatment

NCT04339660

1-2

Recruiting

China

Allogeneic UC-MSC

30

One-two doses of 1 × 106/kg (1 week apart), IV

The immune function, Blood oxygen saturation

NCT04392778

1-2

Recruiting

Turkey

Allogeneic UC-MSC

30 (Placebo:20)

Three doses of 3 × 106 cells/kg on days 0, 3, and 6, IV

Clinical improvement

NCT04355728

1-2

Recruiting

United States

Allogeneic UC-MSC

24 (Placebo:12)

Two doses of 100 × 106 cells, IV

Incidence of pre-specifed infusion-associated adverse events, Incidence of Severe Adverse Events

NCT04371601

1

Active, not recruiting

China

Allogeneic UC-MSC

60

Four single doses of 1 × 106/kg, 4 days apart, IV + Oseltamivir

Changes of oxygenation index, blood gas test

NCT04393415

N/A

Not yet recruiting

Egypt

Allogeneic UC-MSC

100

UC-MSC (undefined dose) + platelet rich plasma (PRP)

The number of patients with positive covid 19 who will improve after receiving stem cells

NCT04452097

1

Not yet recruiting

NA

UC-MSC

39 (Placebo:12)

0.5 million cells/kg, IV, plus standard treatment

Incidence of infusion-related adverse events, Incidence of any treatment-emergent adverse events and treatment emergent serious adverse events

NCT04390139

1-2

Recruiting

Spain

WJ-MSC

30

Two doses, 1 × 106 cells/kg, IV

All-cause mortality at day 28

NCT04333368

1-2

Recruiting

France

Allogeneic WJ-UC-MSC

40 (Placebo:20)

Three doses of 1.0 × 106 cells/kg at days 1, 3, and 5, IV

Respiratory efcacy evaluated by the increase in PaO2/FiO2 ratio from baseline to day 7 in the experimental group compared with the placebo group

NCT04565665

1

N/A

United States

CB-MSC

70

N/A

Incidence of composite serious adverse events (Phase I), Patients alive without grade 3, 4 infusional toxicity (Phase II), Patients alive with grade 3 or 4 infusional toxicity (Phase II), Patients not alive (Phase II)

NCT04377334

2

Not yet recruiting

Germany

Allogeneic BM-MSC

40

N/A

Improvement of lung injury score (LIS), 0-16 points, severity increasing with higher points

NCT04467047

1

Not yet recruiting

Brazil

Allogeneic BM-MSC

10

1 × 106 MSCs/kg, IV

Overall survival

NCT04444271

2

Recruiting

Pakistan

Autologous BM-MSC

20 (Placebo:10)

2 × 106 cells/kg on days 1 and 7 (if needed), IV

Overall survival

NCT04366323

1-2

Recruiting

Spain

Allogeneic adipose MSC

26

Two doses of 8 × 107 cell/dose, IV

Safety of the administration of allogeneic mesenchymal stem cells derived from adipose tissue, Efficacy of the administration of allogeneic mesenchymal stem cells derived from adipose tissue

NCT04348435

2

Enrolling by invitation

United States

Allogeneic adipose MSC

100 (Placebo:25)

Five doses of either 2 × 108, 1 × 108 or 5 × 107 cells/single doses at weeks 0, 2, 6, 10, and 14, IV

Incidence of hospitalization for COVID-19, Incidence of symptoms associated with COVID-19

NCT04382547

1-2

Enrolling by invitation

Belarus

Allogeneic mucosa MSC

40

Dose unspecified, IV

Number of cured patients

NCT04349631

2

Enrolling by invitation

United States

Autologous adipose MSC

56

Five doses of cells (unspecified dose), IV

Incidence of hospitalization for COVID-19, Incidence of symptoms for COVID-19

NCT04346368

1-2

Not yet recruiting

China

BM-MSC

20

Single dose 1 × 106 MSCs/kg, IV

Changes of oxygenation index (PaO2/FiO2), Side efects in the BM-MSC treatment group

NCT04447833

1

Recruiting

N/A

Allogeneic BM-MSC

9

First three patients receive a single dose of 1 × 106 MSCs/kg dose, next six patients receive a single dose of 2 × 106 MSCs/kg, IV

The incidence of pre-specifed treatment-related adverse events of interest (TRAEIs)

NCT04348461

2

Not yet recruiting

Spain

Allogeneic adipose MSC

100

Two doses of 1.5 × 106/kg, IV

Efficacy of the administration of allogeneic mesenchymal stem cells derived from adipose tissue, Safety of the administration of allogeneic mesenchymal stem cells derived from adipose tissue

NCT04362189

2

Not yet recruiting

United States

Allogeneic adipose MSC

100

Four doses of 1.0 × 108 cells at days 0, 3, 7, and 10, IV

D-dimer, Interleukin-6, C Reactive protein, Oxygenation, PCR test SARS-CoV-2

NCT04397796

1

Not yet recruiting

United States

Allogeneic BM-MSC

45

N/A

Incidence of AEs, Mortality, Death, Number of ventilator-free days

NCT04371393

3

Recruiting

United States

Allogeneic BM-MSC

300 (Placebo:150)

Two doses of 2 × 106 MSC/kg (doses 4 days apart ± 1 day), IV + standard of care

Number of all-cause mortality

NCT04341610

1-2

Withdrawn

N/A

Allogeneic adipose MSC

N/A

N/A

Changes in clinical critical treatment index

NCT04400032

1

Not yet recruiting

Canada

BM-MSC

9

Intervention group 1: three doses 25 × 106 at day 0, 1, 3 IV Intervention group 2: three doses 50 × 106 at day 0, 1, 3 IV Intervention group 3: three doses 90 × 106 at day 0, 1, 3, IV

Number of participants with treatment-related adverse events as assessed by CTCAE v4.0

NCT04398303

1-2

Not yet recruiting

United States

Allogeneic WJ-MSC

70

Intervention group 1: 1.0 × 106//kg cells in 100 ml CM+ Conventional treatment Intervention group 2: 100 ml CM+ conventional treatment

Mortality at day 30

NCT04389450

2

Recruiting

N/A

Allogeneic ex vivo expanded placental mesenchymal-like adherent stromal cells

140

N/A

Number of ventilator free days

NCT04345601

1

Not yet recruiting

United States

Allogeneic BM-MSC

30

Single dose of 1 × 108 cells, IV

Incidence of unexpected adverse events, Improved oxygen saturations ≥ 93%

NCT04361942

2

Recruiting

Spain

Allogeneic MSC

24

Single dose of 1 × 106 cells/kg, IV

Proportion of patients who have achieved withdrawal of invasive mechanical ventilation, Rate of mortality

NCT04445220

1-2

Not yet recruiting

United States

Allogeneic MSC

24

Low dose cohort: SBI-101 device containing 250 million MSCs; high dose cohort: SBI-101 device containing 750 million MSCs, extracorporeal

Safety and tolerability as measured by incidence of IP-related serious adverse events

NCT04397471

N/A

Not yet recruiting

United Kingdom

Allogeneic BM-MSC

10

N/A

Determine feasibility of recruiting healthy volunteers in a clinically useful timeframe, Manufacture a cell-based product suitable for clinical use

NCT04428801

2

Not yet recruiting

United States

Autologous adipose MSC

200

200 million every 3 days (3 doses), IV

The overall proportion of subjects who develop any AEs/SAEs related and non-related with the AdMSC infusions as compared to the control group, COVID-19 incidence rates in both the study and control groups

NCT04366271

2

Withdrawn

Spain

Allogeneic UC-MSC

106

Single IV infusion MSCs (dose unspecified) + standard of care

Mortality due to long involvement due to SARS-CoV-2 virus infection at 28 days of treatment. Percentage of patients death due to lung involvement due to SARS-CoV-2 virus infection at 28 days of treatment

NCT04352803

1

Not yet recruiting

N/A

Autologous adipose MSC

20

5 × 105/kg, IV

Incidence of unexpected adverse events, Frequency of progression to mechanical ventilation, Changes in length of mechanical ventilation, Changes in length of weaning of mechanical ventilation, Changes in length of hospital stay, Changes in mortality rate

NCT03042143

1-2

Recruiting

United Kingdom

Allogeneic WJ-MSC

75

Single dose of 4 × 108 cells, IV

Oxygenation index (OI), Incidence of Serious Adverse Events (SAEs)

NCT04367077

2-3

Recruiting

United States

BM-MSC

400

Dose unspecified, IV

Ventilator-Free Days, Safety and Tolerability as measured by the incidence of treatment-emergent adverse events as assessed by CTCAE v5.0.

NCT04535856

1

N/A

Indonesia

Allogeneic MSC

9

N/A

Incidence of Treatment-Emergent Adverse Event (TEAE) in Treatment Group

ChiCTR2000029990

2

Recruiting

China

MSC

120 (Placebo:60)

1 × 106 per kg of weight, IV

Improved respiratory system function (blood oxygen saturation) recovery time

ChiCTR2000029569

N/A

Not recruiting

China

UC-MSC

30 (Placebo:15)

N/A

N/A

ChiCTR2000030138

2

Not recruiting

China

UC-MSC

60 (Placebo:30)

Dose unspecified, IV

N/A

ChiCTR2000031494

1

Recruiting

China

UC-MSC

36 (Placebo:18)

Dose unspecified, IV

N/A

ChiCTR2000031430

2

Recruiting

China

UC-MSC

200 (Placebo:100)

4 × 107 cells/application on days 0, 3, and 6 for a total of 3 times, IV

N/A

Table 1 shows clinical trials using MSCs for the treatment of ARDS due to COVID-19. The data were obtained from clinicaltrials.gov and chictr.org.cn, and these studies can be reviewed on the site with their identifier numbers. In the table, the sources of MSCs used for treatment, the phase of the study, the number of people enrolled in the study, the current status of the study and the countries where the studies were conducted can be seen.

Abbreviations: CT: Computerized Tomography; MSC: Mesenchymal Stem Cell; N/A: Not Available; RT-PCR: Real-Time Polymerase Chain Reaction; CB-MSC: Cord Blood Mesenchymal Stem Cell; UC-MSC: Umbilical Cord Mesenchymal Stem Cell; WJ-MSC: Wharton’s Jelly Mesenchymal Stem Cell; BM-MSC: Bone Marrow Mesenchymal Stem Cell