摘要： A coronavirus (HCoV-19) has caused the novel coronavirus disease (COVID-19) outbreak in Wuhan, China, Preventing and reversing the cytokine storm may be the key to save the patients with severe COVID-19 pneumonia. Mesenchymal stem cells (MSCs) have been shown to possess a comprehensive powerful immunomodulatory function. This study aims to investigate whether MSC transplantation improve the outcome of 7 enrolled patients with COVID-19 pneumonia in Beijing YouAn Hospital, China from Jan 23, 2020. to Feb 16, 2020. The clinical outcomes, as well as changes of inflammatory and immune function levels and adverse effects of 7 enrolled patients were assessed for 14 days after MSC injection. MSCs could cure or significantly improve the functional outcomes of seven patients with COVID-19 pneumonia in 14 days without observed adverse effect. The pulmonary function and symptoms of all patients with COVID-19 pneumonia were significantly improved in 2 days after MSC transplantation. Among them, two common and one severe patient were recovered and discharged in 10 days after treatment. After treatment, the peripheral lymphocytes were increased and the overactivated cytokine-secreting immune cells CXCR3 CD4 T cells, CXCR3 CD8 T cells, and CXCR3 NK cells were disappeared in 3-6 days. And a group of CD14 CD11c CD11bmid regulatory DC cell population dramatically increased. Meanwhile, the level TNF-α is significantly decreased while IL-10 increased in MSC treatment group compared to the placebo control group. Furthermore, the gene expression profile showed MSCs were ACE2- and TMPRSS2- which indicated MSCs are free from COVID-19 infection. Thus, the intravenous transplantation of MSCs was safe and effective for treatment in patients with COVID-19 pneumonia, especially for the patients in critically severe condition.
摘要： Background: The efficient transmission of Severe Acute Respiratory Syndrome-2 Coronavirus (SARS-CoV-2) from patients to healthcare workers or family members has been a worrisome and prominent feature of the ongoing outbreak. On the basis of clinical practice and in-vitro studies, we postulated that post-exposure prophylaxis (PEP) using Arbidol is associated with decreased infection among individuals exposed to confirmed cases of COVID-19 infection. Methods: We conducted a retrospective case-control study on family members and health care workers who were exposed to patients confirmed to have SARS-CoV-2 infection by real-time RT-PCR and Chest CT from January 1 to January 16, 2020. We collected demographic information, work location of exposure, post-exposure prophylaxis information, and symptoms, if any, 24 days after exposure. The relation between post-exposure prophylaxis and infection in household contacts and healthcare workers were respectively analyzed. Results: 27 families and 124 health care workers had evidence of close exposure to patients with confirmed COVID-19. There were no differences in age, profession and sex distribution in the two groups with different post-exposure prophylaxis, table 1. Logistic regression based on the data of the family members and health care workers with Arbidol or Oseltamivir prophylaxis showed that Arbidol PEP was a strong protective factor against the development of COVID-19 (Odds ratio 0·011 , 95% CI 0·001-0·125, P=0·0003 for family members and Odds ratio 0·049, 95%CI 0·003-0·717), P= 0·0276 for health care workers). On the contrary, Oseltamivir was associated with an increase in COVID-19 infection (Odds ratio 20·446, 95% CI 1·407-297·143, P= 0·0271). Conclusions: Our findings suggest Arbidol could reduce the infection risk of the novel coronavirus in hospital and family settings. This treatment should be promoted for PEP use and should be the subject of further investigation.