MEZENKİMAL KÖK HÜCRE TEDAVİSİ UYGULANAN COVID-19 HASTALARININ SEYRİ

Year 2023, , 40 - 45, 28.02.2023

Hayri Canbaz , Hikmet Can Çubukçu , Ahmet Demir , Fatih Kacıroğlu , Seher Taş , Alpay Tuncar , Mehmet Ferit Fedai , Murat Gülşen , Attila Beştemir

https://doi.org/10.26650/JARHS2023-1226757

Abstract

Giriş: Birkaç ülke, doku onarımı ve anti-inflamatuar mekanizmalar yoluyla terapötik etkilerini göz önünde bulundurarak, Koronavirüs-19 (COVID-19) hastalarını tedavi etmek için klinik deneylerde mezenkimal kök hücreleri (MKH) kullanmıştır. Bu çalışma, COVID-19 pnömoni hastalarında MKH uygulamasının klinik ve inflamatuar parametreler ve yaşam beklentisi üzerindeki erken etkilerini araştırmak amaçladı. Gereç ve Yöntem: Türkiye Cumhuriyeti Sağlık Bakanlığı Doku, Organ Nakli ve Diyaliz Hizmetleri Daire Başkanlığı’na başvuran ve 1 Mart 2020 - 1 Mart 2021 tarihleri arasında MKH uygulaması için başvurusu olan COVID-19 pnömonisi (tüm yaş grupları) olan aşılanmamış 164 hastayı geriye dönük olarak inceledik. Bulgular: Kaplan Mayer sağkalım analizi kullanılarak, kırılım yaşı (hayatta kalma riskini önemli ölçüde artıran) 61 yıl olarak bulundu. Kadınlar erkeklere göre 1.56 kat daha fazla ölüm riskine sahipti. Hastaların %68’inde (113/164) komorbidite mevcuttu ve bu komorbiditesi olmayanlara göre ölüm riskini 1,58 kat artırıyordu. Koroner arter hastalığı varlığı ölüm riskini 1,79 kat artırdı. Ayrıca, entübe hastalarda entübe olmayanlara göre ölüm riski 7 kat daha yüksekti (%95 GA: 3.72-13.17). Maalesef hastaların %64’ü (106/164) öldü. Son olarak, MKH sonrası tedavi medyan Sıralı Organ Yetmezliği Değerlendirme Skoru (SOFA) değerlerinde uygulama sırasında, 3, 7, 14. günlerde ve sonuna kadar (taburcu/ölüm) istatistiksel olarak anlamlı bir artış oldu. Sonuç: Bu çalışma aşılanmamış hastalarla yapılmıştır ve COVID-19 ile ilişkili pnömoni için MKH tedavisi yeterince etkili değildir.

Keywords

Koronavirüs, COVID-19, mezenkimal kök hücre, mortalite, sağ kalım

CLINICAL COURSE OF COVID-19 PATIENTS UNDER MESENCHYMAL STEM CELL THERAPY

Abstract

Objective: Several countries have used mesenchymal stem cells (MSCs) in clinical trials for treating Coronavirus-19 (COVID-19) patients, considering their therapeutic effects through tissue repair and anti-inflammatory mechanisms. This study aimed to investigate the early effects of MSC application in COVID-19 pneumonia patients on clinical and inflammatory parameters and life expectancy. Material and Method: We retrospectively analyzed 164 unvaccinated patients with COVID-19 pneumonia (all age groups) who had applied to the Republic of Turkiye, Ministry of Health, Department of Tissue, Organ Transplantation, and Dialysis Services and received the MSC application from March 1, 2020 to March 1, 2021. Results: Using the Kaplan Mayer survival analysis, the cut-off age (which significantly increased the survival risk) was found to be 61 years. Females had a 1.56 times higher risk of death than males. Sixty-eight percent (113/164) of the patients had a comorbidity, which increased the risk of death by 1.58 times compared to those without any comorbidity. The presence of coronary artery disease increased the risk of death by 1.79 times. Further, the risk of death was 7 times higher in intubated patients than in those who were not (95% CI: 3.72–13.17). Unfortunately, 64% (106/164) of the patients died. Lastly, there was a statistically significant increase in the post-MSC treatment median Sequential Organ Failure Assessment Score (SOFA) score values at the time of application, on days 3, 7, 14, and until the end (discharge/exitus). Conclusion: This study was conducted with unvaccinated patients and MSC treatment for COVID-19-related pneumonia is not adequately effective.

Keywords

Coronavirus, COVID-19, mesenchymal stem cell, mortality, survival

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