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Use of UC-MSCs for COVID-19 Patients

Umbilical Cord-derived Mesenchymal Stem Cells for COVID-19 Patients With Acute Respiratory Distress Syndrome (ARDS)

Status
Completed
Phases
Phase 1Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04355728
Enrollment
24
Registered
2020-04-21
Start date
2020-04-25
Completion date
2020-10-31
Last updated
2021-12-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Acute Respiratory Distress Syndrome, ARDS, ARDS, Human, Corona Virus Infection, COVID-19

Keywords

COVID-19

Brief summary

The purpose of this research study is to learn about the safety and efficacy of human umbilical cord derived Mesenchymal Stem Cells (UC-MSC) for treatment of COVID-19 Patients with Severe Complications of Acute Lung Injury/Acute Respiratory Distress Syndrome (ALI/ARDS).

Interventions

BIOLOGICALUmbilical Cord Mesenchymal Stem Cells + Heparin along with best supportive care.

UC-MSC will be administered at 100x10\^6 cells/infusion administered intravenously in addition to the standard of care treatment.

OTHERVehicle + Heparin along with best supportive care

Best supportive care treatment per the treating hospital protocol.

Sponsors

Camillo Ricordi
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)

Masking description

Double-Blinding Trial

Intervention model description

The trial has two groups, each with 12 subjects (n=24). All eligible subjects will be randomized to either the treatment group or standard of care, and randomization will be stratified by ARDS severity.

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

Patients \>/= 18 years old diagnosed with COVID-19 (as evaluated by PCR test confirming infection with SARS-CoV-2) will be eligible for inclusion if they meet all of the below criteria. Inclusion criteria must all be present within a 24-hour time period at the time of enrollment: 1. Patient currently hospitalized 2. Aged ≥ 18 years 3. Willing and able to provide written informed consent, or with a legal representative who can provide informed consent 4. Peripheral capillary oxygen saturation (SpO2) ≤ 94% at room air, or requiring supplemental oxygen at screening 5. PaO2/FiO2 ratio \< 300 mmHg 6. Bilateral infiltrates on frontal chest radiograph or bilateral ground glass opacities on a chest CT scan 7. Hypoxemia requiring an increase in the fraction of inspired oxygen (FiO2) of ≥ 20% AND an increase in positive end-expiratory airway pressure (PEEP) level of 5 cm H2O or more to maintain transcutaneous oxygen saturations in the target range of 88-95%, or requirement for escalation from oxygen therapy to invasive mechanical ventilation

Exclusion criteria

1. PaO2/FiO2 ≥ 300 at the time of enrollment 2. A previous MSC infusion not related to this trial 3. History of Pulmonary Hypertension (WHO Class III/IV) 4. History of left atrial hypertension or decompensated left heart failure. 5. Pregnant or lactating patient 6. Unstable arrhythmia 7. Patients with previous lung transplant 8. Patients currently receiving chronic dialysis 9. Patients currently receiving Extracorporeal Membrane Oxygenation (ECMO) 10. Presence of any active malignancy (except non-melanoma skin cancer) 11. Any other irreversible disease or condition for which 6-month mortality is estimated to be greater than 50% 12. Moderate to severe liver disease (AST and ALT \>5 X ULN) 13. Severe chronic respiratory disease with a PaCO2 \> 50 mm Hg or the use of home oxygen 14. Baseline QT prolongation 15. Moribund patient not expected to survive \> 24 hours

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With Pre-Specified Infusion Associated Adverse Events6 and 24 hoursSafety as defined by the number of pre-specified infusion associated adverse events as assessed by treating physician. Any of the following occurring within 6 h post each infusion: 1. An increase in vasopressor dose greater than or equal to the following: * Norepinephrine: 10 μg/min * Phenylephrine: 100 μg/min * Dopamine: 10 μg/kg/min * Epinephrine: 10 μg/min 2. In patients receiving mechanical ventilation: worsening hypoxemia, as assessed by a requirement for an increase of PEEP by 5 cm H2O over baseline, or requirement to increase FiO2 of \>20%. 3. In patients receiving high flow oxygen therapy: worsening hypoxemia, as indicated by requirement of intubation and mechanical ventilation. 4. New cardiac arrhythmia requiring cardioversion 5. New ventricular tachycardia, ventricular fibrillation, or asystole 6. A clinical scenario consistent with transfusion incompatibility or transfusion-related infection 7. Cardiac arrest or death within 24h post infusion
Number of Subjects With Serious Adverse Events by 31 Days After First Infusion31 daysThe number of subjects experiencing serious adverse events by 31 days after the first infusion (corresponding to 28 days after the last infusion).
Percentage of Participants Experiencing Serious Adverse Events (SAEs) Through Study Day 9090 daysSafety will be reported as the percentage of participants experiencing serious adverse events through Day 90 as assessed by treating physician.
Number of Adverse Events (AEs) and Serious Adverse Events (SAEs)90 daysTotal number of adverse events and serious adverse events as assessed by treating physician
Number of Adverse Events (AEs) and Serious Adverse Events (SAEs) by Severity90 daysTotal number of adverse events plus serious adverse events categorized by severity.
Subjects With Adverse Events and Serious Adverse Events by Severity90 daysTotal number of subjects with adverse events and serious adverse events categorized by severity.
Number of Adverse Events and Serious Adverse Events by Relatedness to Treatment90 daysTotal number of adverse events and serious adverse events categorized by relatedness to treatment defined by a medical professional.
Subjects With Adverse Events by Relatedness to Treatment90 daysTotal number of subjects with adverse events categorized by relatedness to treatment by a medical professional

Secondary

MeasureTime frameDescription
Sequential Organ Failure Assessment (SOFA) ScoresDay 6Sequential Organ Failure Assessment (SOFA) Scores is used to track a person's risk status during stay in the Intensive Care Unit (ICU). The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal, and neurological systems. Each organ system is assigned a point value from a minimum of 0 (normal) to a maximum of 4 (high degree of dysfunction/failure). The total score corresponds to the sum of the six different scores of the organ systems. In total, the minimum SOFA score is 0 (normal) and the maximum SOFA score is 24 (highest degree dysfunction/failure).
Smell Identification Test (SIT) Scores90 daysSIT measures the participant's sense of smell. SIT has a total score ranging from 0 to 40 with the higher the score indicating a more normal sense of smell
White Blood Cell Count (WBC)day 6As assessed via serum blood samples.
Platelets Countday 6As assessed via serum blood samples.
Hemogoblinday 6Measures the total amount of the oxygen-carrying protein in the blood as assessed via serum blood samples.
Alkaline Phosphataseday 6Alkaline phosphatase levels as assessed via serum blood samples for the Comprehensive Metabolic Panel.
Hematocritday 6The percentage by volume of red cells in your blood as assessed via serum blood samples.
Neutrophilsday 6the amount of immune cells (that is one of the first cell types to travel to the site of an infection) as assessed via serum blood samples
Lymphocytesday 6Lymphocyte count as assessed via serum blood samples
Glomerular Filtration Rateday 6Glomerular filtration rate (GFR) as assessed via serum blood samples to check how well the kidneys are working. It estimates how much blood passes through the glomeruli each minute.
Total ProteinDay 6Total protein as assessed via serum blood samples as a part of the comprehensive metabolic panel (CMP). It is a measurement of the sum of albumin and globulins.
Sodiumday 6Sodium levels as assessed by serum blood samples.
Potassiumday 6Potassium levels as assessed via serum blood samples.
Creatinineday 6Creatinine levels as assessed via serum blood samples
Glucoseday 6Glucose levels as assessed via serum blood samples
Albuminday 6Albumin levels as assessed via serum blood samples
Alanine Aminotransferase or Serum Glutamate-pyruvate Transaminase (ALT or SGPT)day 6The alanine aminotransferase or serum glutamate-pyruvate transaminase (ALT or SGPT) test as assessed via serum blood samples
Aspartate Aminotransferase or Serum Glutamic Oxaloacetic Transaminase (AST or SGOT)day 6The aspartate aminotransferase or serum glutamic oxaloacetic transaminase (AST or SGOT) test as assessed via serum blood samples
Total Bilirubinday 6Bilirubin levels as assessed via serum blood samples for the comprehensive metabolic panel.
Blood Urea Nitrogen (BUN)day 6Blood urea nitrogen (BUN) levels as assessed via serum blood samples for the comprehensive metabolic panel.
Calciumday 6Calcium levels as assessed via serum blood samples for the comprehensive metabolic panel.
Chlorideday 6Chloride levels as assessed via serum blood samples for the comprehensive metabolic panel.
Carbon Dioxide (CO2)day 6Carbon Dioxide (CO2) levels as assessed via serum blood samples for the comprehensive metabolic panel.
Survival at 31 Days Post First Infusion31 DaysNumber of participants that are alive at 31 days post first infusion follow up corresponding to 28 day post second infusion.
Arachidonic Acid/Eicosapentaenoic Acid (AA/EPA) Ratioday 6As assessed via serum blood samples on day 6 (visit 8).
D-dimer Levelsday 6As assessed via serum blood samples.
25-Hydroxy Vitamin D Levelsday 6As assessed via serum blood samples.
Tumor Necrosis Factor-alpha (TNFα)day 6Analysis of TNFα in peripheral blood plasma
Tumor Necrosis Factor-beta (TNFβ)day 6Analysis of TNFβ in peripheral blood plasma
Soluble Tumor Necrosis Factor Receptor 2 (sTNFR2)day 6Analysis of soluble tumor necrosis factor receptor 2 (sTNFR2) in peripheral blood plasma
Viral Load by SARS-CoV-2 RT-PCRday 6Viral load as assessed in blood plasma for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) via Reverse Transcriptase Polymerase Chain Reaction (RT-PCR).
Number of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 3 Post First Infusionday 3 post first infusionNumber of participants reporting panel reactive antibody (PRA) positivity at Day 3 post first infusion for class I and class II as assessed via serum blood samples. These antibodies can develop following a transplant. Recipients can become sensitized to certain molecules (Human Leukocyte Antigen Class I or Class II), which can affect immune responses to and rejection of potential future transplants.
Number of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 6 Post First Infusionday 6Number of participants reporting panel reactive antibody (PRA) positivity at Day 6 post first infusion for class I and class II as assessed via serum blood samples. These antibodies can develop following a transplant. Recipients can become sensitized to certain molecules (Human Leukocyte Antigen Class I or Class II), which can affect immune responses to and rejection of potential future transplants.
Number of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 14 Post First Infusionday 14Number of participants reporting panel reactive antibody (PRA) positivity at Day 14 post first infusion for class I and class II as assessed via serum blood samples. These antibodies can develop following a transplant. Recipients can become sensitized to certain molecules (Human Leukocyte Antigen Class I or Class II), which can affect immune responses to and rejection of potential future transplants.
Number of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGday 14 post first infusionNumber of participants with positive, negative, or borderline SARS-CoV-2 Immunoglobulin M (IgM)/Immunoglobulin G (IgG) serology from serum blood samples.
C-Reactive Protein Levelsday 6As assessed via serum blood samples.
Survival at 60 Days Post First Infusion60 daysNumber of participants alive at 60 days post first infusion follow up.
Time to Recovery31 daysTime to discharge or, if the subject was hospitalized, no longer requiring supplemental oxygen and no longer requiring COVID-19-related medical care by 31 days. The numbers represent days at which 25%, 50%, 75% subjects within the treatment group had recovered.
Ventilator-Free Days Throughout 28 Days Post Second Infusion28 days post second infusionNumber of days participants were off ventilators during 28 days post second infusion.
Ventilator-Free Days Throughout 90 Days90 days or hospital discharge, whichever is earlierNumber of days participants were off ventilators within up to 90 days of hospitalization.
Respiratory Rate and Oxygenation Index (ROX Index)day 6Respiratory Rate-Oxygenation (ROX) index is defined as the ratio of oxygen saturation as measured by pulse oximetry (SpO2)/ Fraction of inspired oxygen (FiO2) to respiratory rate. This index can be used in the assessment of disease progression and the risk of intubation in COVID-19 patients with pneumonia.
Oxygenation Index (OI)day 6Measure of the fraction of inspired oxygen (FiO2) and its usage within the body during intensive care, measured using fNIRS (Functional Near Infrared Spectroscopy). The calculation for Oxygenation index is ((FIO2 \* Mean airway pressure)/partial pressure of oxygen).
Positive End-Expiratory Pressure (PEEP) and Plateau Pressure (Pplat)day 6Measuring the respiratory mechanics; positive end-expiratory pressure (PEEP) and plateau pressure (Pplat) in ventilated patients visit 8 (day 6)

Countries

United States

Participant flow

Participants by arm

ArmCount
UC-MSCs Group
Participants in this group will be treated with two infusions of UC-MCSs along with heparin (blood thinner) in addition to standard of care treatment. The first infusion will be administered within 24 hours of study enrollment and the second infusion will be administered within 72 hours of study enrollment. Umbilical Cord Mesenchymal Stem Cells + Heparin along with best supportive care.: UC-MSC will be administered at 100x10\^6 cells/infusion administered intravenously in addition to the standard of care treatment.
12
Control Group
Participants in this group will be treated with two infusions of vehicle along with heparin (blood thinner) in addition to standard of care treatment. The first infusion will be administered within 24 hours of study enrollment and the second infusion will be administered within 72 hours of study enrollment. Vehicle + Heparin along with best supportive care: Best supportive care treatment per the treating hospital protocol.
12
Total24

Baseline characteristics

CharacteristicTotalUC-MSCs GroupControl Group
25-OH vitamin D levels22.47 ng/ml
STANDARD_DEVIATION 10.68
21.76 ng/ml
STANDARD_DEVIATION 8.48
23.19 ng/ml
STANDARD_DEVIATION 12.85
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
9 Participants4 Participants5 Participants
Age, Categorical
Between 18 and 65 years
15 Participants8 Participants7 Participants
Age, Continuous58.71 years
STANDARD_DEVIATION 13.63
58.58 years
STANDARD_DEVIATION 15.93
58.83 years
STANDARD_DEVIATION 11.61
Alanine Aminotransferase (ALT) or Serum Glutamic-pyruvic Transaminase (SGPT)77.52 U/L
STANDARD_DEVIATION 63.51
72.1 U/L
STANDARD_DEVIATION 51.19
82.45 U/L
STANDARD_DEVIATION 75.18
Albumin for Comprehensive Metabolic Panel3.22 g/dL
STANDARD_DEVIATION 0.44
3.22 g/dL
STANDARD_DEVIATION 0.39
3.21 g/dL
STANDARD_DEVIATION 0.51
Alkaline Phosphatase for Comprehensive Metabolic Panel93.7 U/L
STANDARD_DEVIATION 54.67
90.9 U/L
STANDARD_DEVIATION 59.3
96.5 U/L
STANDARD_DEVIATION 52.69
Arachidonic Acid/Eicosapentaenoic Acid (AA/EPA) Ratio45.58 ratio of AA to EPA
STANDARD_DEVIATION 23.88
45.38 ratio of AA to EPA
STANDARD_DEVIATION 24.89
45.79 ratio of AA to EPA
STANDARD_DEVIATION 23.93
Aspartate Aminotransferase (AST) or Serum Glutamic-Oxaloacetic Transaminase (SGOT)88.62 U/L
STANDARD_DEVIATION 114.86
55.8 U/L
STANDARD_DEVIATION 31.07
118.45 U/L
STANDARD_DEVIATION 153.16
Blood Urea Nitrogen (BUN) for Comprehensive Metabolic Panel36.13 mg/dL
STANDARD_DEVIATION 25.38
29.58 mg/dL
STANDARD_DEVIATION 16.61
42.67 mg/dL
STANDARD_DEVIATION 31.27
Calcium for Comprehensive Metabolic Panel8.43 mg/dL
STANDARD_DEVIATION 0.67
8.53 mg/dL
STANDARD_DEVIATION 0.4
8.32 mg/dL
STANDARD_DEVIATION 0.87
Carbon Dioxide (CO2) for Comprehensive Metabolic Panel23.17 mmol/L
STANDARD_DEVIATION 4.41
24.42 mmol/L
STANDARD_DEVIATION 3.99
21.92 mmol/L
STANDARD_DEVIATION 4.62
Chloride Comprehensive Metabolic Panel100.75 mmol/L
STANDARD_DEVIATION 5.29
101 mmol/L
STANDARD_DEVIATION 4.29
100.5 mmol/L
STANDARD_DEVIATION 6.33
C-Reactive Protein (CRP)121.16 mg/L
STANDARD_DEVIATION 99.19
97.97 mg/L
STANDARD_DEVIATION 77.56
144.35 mg/L
STANDARD_DEVIATION 115.69
Creatine for Comprehensive Metabolic Panel1.55 mg/dL
STANDARD_DEVIATION 1.46
1.18 mg/dL
STANDARD_DEVIATION 0.77
1.92 mg/dL
STANDARD_DEVIATION 1.88
D-Dimer3.29 mcg/mL FEU
STANDARD_DEVIATION 4.69
1.76 mcg/mL FEU
STANDARD_DEVIATION 2.35
4.96 mcg/mL FEU
STANDARD_DEVIATION 6.04
Ethnicity (NIH/OMB)
Hispanic or Latino
22 Participants11 Participants11 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
2 Participants1 Participants1 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Glomerular Filtration Rate from Comprehensive Metabolic Panel67.88 mL/min/1.73 m^2
STANDARD_DEVIATION 34.63
74.5 mL/min/1.73 m^2
STANDARD_DEVIATION 31.61
61.25 mL/min/1.73 m^2
STANDARD_DEVIATION 37.59
Glucose for Comprehensive Metabolic Panel192.21 mg/dL
STANDARD_DEVIATION 94.78
190.75 mg/dL
STANDARD_DEVIATION 107.14
193.67 mg/dL
STANDARD_DEVIATION 85.44
Hematocrit from Complete Blood Count40.18 percentage of total blood volume
STANDARD_DEVIATION 5.79
39.71 percentage of total blood volume
STANDARD_DEVIATION 6.53
40.76 percentage of total blood volume
STANDARD_DEVIATION 5.08
Hemogoblin from Complete Blood Count12.69 g/dL
STANDARD_DEVIATION 2.17
12.93 g/dL
STANDARD_DEVIATION 2.04
12.45 g/dL
STANDARD_DEVIATION 2.35
Lymphocytes from Complete Blood Count0.95 10^3 cells/uL
STANDARD_DEVIATION 0.62
1.15 10^3 cells/uL
STANDARD_DEVIATION 0.79
0.72 10^3 cells/uL
STANDARD_DEVIATION 0.25
Neutrophils from Complete Blood Count11.21 10^3 cells/uL
STANDARD_DEVIATION 5.36
9.25 10^3 cells/uL
STANDARD_DEVIATION 4.8
13.37 10^3 cells/uL
STANDARD_DEVIATION 5.33
Oxygenation Index11.83 Index
STANDARD_DEVIATION 11.5
8.09 Index
STANDARD_DEVIATION 2.63
14.32 Index
STANDARD_DEVIATION 14.68
Panel Reactive Antibody (PRA)
PRA Results Class I
Negative PRA
4 Participants1 Participants3 Participants
Panel Reactive Antibody (PRA)
PRA Results Class I
Positive PRA
20 Participants11 Participants9 Participants
Panel Reactive Antibody (PRA)
PRA Results Class II
Negative PRA
14 Participants8 Participants6 Participants
Panel Reactive Antibody (PRA)
PRA Results Class II
Positive PRA
10 Participants4 Participants6 Participants
Plateau Pressure21.38 cm H2O
STANDARD_DEVIATION 11.43
13.75 cm H2O
STANDARD_DEVIATION 9.74
29 cm H2O
STANDARD_DEVIATION 7.39
Platelet count from Complete Blood Count336.21 10^3 cells/uL
STANDARD_DEVIATION 93.88
329.83 10^3 cells/uL
STANDARD_DEVIATION 99.52
342.58 10^3 cells/uL
STANDARD_DEVIATION 91.83
Positive End-Expiratory Pressure (PEEP)13.09 cm H2O
STANDARD_DEVIATION 2.07
13.75 cm H2O
STANDARD_DEVIATION 2.06
12.71 cm H2O
STANDARD_DEVIATION 2.14
Potassium for Comprehensive Metabolic Panel4.44 mmol/L
STANDARD_DEVIATION 0.6
4.37 mmol/L
STANDARD_DEVIATION 0.55
4.52 mmol/L
STANDARD_DEVIATION 0.67
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
3 Participants1 Participants2 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
21 Participants11 Participants10 Participants
Region of Enrollment
United States
24 participants12 participants12 participants
Respiratory Rate and Oxygenation Index (ROX)5.91 Index
STANDARD_DEVIATION 6.24
7.36 Index
STANDARD_DEVIATION 7.73
3.59 Index
STANDARD_DEVIATION 1.13
Sequential Organ Failure Assessment (SOFA) Score6.52 score on a scale
STANDARD_DEVIATION 3.12
5.5 score on a scale
STANDARD_DEVIATION 2.61
7.64 score on a scale
STANDARD_DEVIATION 3.35
Serology (anti-SARS-CoV-2 IgM and IgG)
IgG
Borderline
1 Participants1 Participants0 Participants
Serology (anti-SARS-CoV-2 IgM and IgG)
IgG
Negative
5 Participants4 Participants1 Participants
Serology (anti-SARS-CoV-2 IgM and IgG)
IgG
Positive
13 Participants5 Participants8 Participants
Serology (anti-SARS-CoV-2 IgM and IgG)
IgM
Borderline
2 Participants0 Participants2 Participants
Serology (anti-SARS-CoV-2 IgM and IgG)
IgM
Negative
8 Participants6 Participants2 Participants
Serology (anti-SARS-CoV-2 IgM and IgG)
IgM
Positive
9 Participants4 Participants5 Participants
Sex: Female, Male
Female
11 Participants7 Participants4 Participants
Sex: Female, Male
Male
13 Participants5 Participants8 Participants
Sodium for Comprehensive Metabolic Panel137.75 mmol/L
STANDARD_DEVIATION 4.28
138.92 mmol/L
STANDARD_DEVIATION 3.15
136.58 mmol/L
STANDARD_DEVIATION 5.04
Total Bilirubin for Comprehensive Metabolic Panel0.64 mg/dL
STANDARD_DEVIATION 0.32
0.62 mg/dL
STANDARD_DEVIATION 0.39
0.65 mg/dL
STANDARD_DEVIATION 0.25
Total Protein from Comprehensive Metabolic Panel6.42 g/dL
STANDARD_DEVIATION 0.67
6.39 g/dL
STANDARD_DEVIATION 0.69
6.45 g/dL
STANDARD_DEVIATION 0.68
Viral Load by SARS-CoV-2 RT-PCR710 copies352 copies3570.50 copies
White Blood Count (WBC) from Complete Blood Count13.02 10^3 cells/uL
STANDARD_DEVIATION 5.37
11.87 10^3 cells/uL
STANDARD_DEVIATION 5.26
14.17 10^3 cells/uL
STANDARD_DEVIATION 5.45

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
3 / 127 / 12
other
Total, other adverse events
8 / 1210 / 12
serious
Total, serious adverse events
5 / 128 / 12

Outcome results

Primary

Number of Adverse Events (AEs) and Serious Adverse Events (SAEs)

Total number of adverse events and serious adverse events as assessed by treating physician

Time frame: 90 days

ArmMeasureGroupValue (NUMBER)
UC-MSCs GroupNumber of Adverse Events (AEs) and Serious Adverse Events (SAEs)Number of Adverse Events (not including SAEs)40 Adverse Events
UC-MSCs GroupNumber of Adverse Events (AEs) and Serious Adverse Events (SAEs)Number of Serious Adverse Events6 Adverse Events
Control GroupNumber of Adverse Events (AEs) and Serious Adverse Events (SAEs)Number of Adverse Events (not including SAEs)37 Adverse Events
Control GroupNumber of Adverse Events (AEs) and Serious Adverse Events (SAEs)Number of Serious Adverse Events16 Adverse Events
Primary

Number of Adverse Events (AEs) and Serious Adverse Events (SAEs) by Severity

Total number of adverse events plus serious adverse events categorized by severity.

Time frame: 90 days

ArmMeasureGroupValue (NUMBER)
UC-MSCs GroupNumber of Adverse Events (AEs) and Serious Adverse Events (SAEs) by SeverityMild15 Adverse Events
UC-MSCs GroupNumber of Adverse Events (AEs) and Serious Adverse Events (SAEs) by SeverityModerate22 Adverse Events
UC-MSCs GroupNumber of Adverse Events (AEs) and Serious Adverse Events (SAEs) by SeveritySevere9 Adverse Events
Control GroupNumber of Adverse Events (AEs) and Serious Adverse Events (SAEs) by SeverityMild13 Adverse Events
Control GroupNumber of Adverse Events (AEs) and Serious Adverse Events (SAEs) by SeverityModerate21 Adverse Events
Control GroupNumber of Adverse Events (AEs) and Serious Adverse Events (SAEs) by SeveritySevere19 Adverse Events
Primary

Number of Adverse Events and Serious Adverse Events by Relatedness to Treatment

Total number of adverse events and serious adverse events categorized by relatedness to treatment defined by a medical professional.

Time frame: 90 days

ArmMeasureGroupValue (NUMBER)
UC-MSCs GroupNumber of Adverse Events and Serious Adverse Events by Relatedness to TreatmentUnlikely3 Adverse Events
UC-MSCs GroupNumber of Adverse Events and Serious Adverse Events by Relatedness to TreatmentProbably0 Adverse Events
UC-MSCs GroupNumber of Adverse Events and Serious Adverse Events by Relatedness to TreatmentPossible1 Adverse Events
UC-MSCs GroupNumber of Adverse Events and Serious Adverse Events by Relatedness to TreatmentDefinite0 Adverse Events
UC-MSCs GroupNumber of Adverse Events and Serious Adverse Events by Relatedness to TreatmentUnrelated42 Adverse Events
Control GroupNumber of Adverse Events and Serious Adverse Events by Relatedness to TreatmentDefinite0 Adverse Events
Control GroupNumber of Adverse Events and Serious Adverse Events by Relatedness to TreatmentUnrelated45 Adverse Events
Control GroupNumber of Adverse Events and Serious Adverse Events by Relatedness to TreatmentUnlikely7 Adverse Events
Control GroupNumber of Adverse Events and Serious Adverse Events by Relatedness to TreatmentPossible1 Adverse Events
Control GroupNumber of Adverse Events and Serious Adverse Events by Relatedness to TreatmentProbably0 Adverse Events
Primary

Number of Participants With Pre-Specified Infusion Associated Adverse Events

Safety as defined by the number of pre-specified infusion associated adverse events as assessed by treating physician. Any of the following occurring within 6 h post each infusion: 1. An increase in vasopressor dose greater than or equal to the following: * Norepinephrine: 10 μg/min * Phenylephrine: 100 μg/min * Dopamine: 10 μg/kg/min * Epinephrine: 10 μg/min 2. In patients receiving mechanical ventilation: worsening hypoxemia, as assessed by a requirement for an increase of PEEP by 5 cm H2O over baseline, or requirement to increase FiO2 of \>20%. 3. In patients receiving high flow oxygen therapy: worsening hypoxemia, as indicated by requirement of intubation and mechanical ventilation. 4. New cardiac arrhythmia requiring cardioversion 5. New ventricular tachycardia, ventricular fibrillation, or asystole 6. A clinical scenario consistent with transfusion incompatibility or transfusion-related infection 7. Cardiac arrest or death within 24h post infusion

Time frame: 6 and 24 hours

Population: In the UC-MSC treatment group, 4 participants were on mechanical ventilation and 8 participants were receiving high flow oxygen therapy. In the control group 7 participants were on mechanical ventilation and 5 participants were receiving high flow oxygen therapy.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
UC-MSCs GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsIn subjects on high flow oxygen therapy:worsening hypoxemia(req intubat, mechanical ventilat) at 6 h0 Participants
UC-MSCs GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsNumber of subjects with new ventricular tachycardia, ventricular fibrillation, or asystole at 6 h0 Participants
UC-MSCs GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsIn subjects receiving mechanical ventilation, Number of subjects with worsening of hypoxemia at 6 h1 Participants
UC-MSCs GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsA clinical scenario consistent with transfusion incompatibility or transfusion-rel infection at 6h0 Participants
UC-MSCs GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsNumber of subjects with new cardiac arrhythmia requiring cardioversion at 6 h0 Participants
UC-MSCs GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsNumber of subjects with cardiac arrest or death within 24 h post infusion0 Participants
UC-MSCs GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsNumber of subjects with an increase in vasopressor dose at 6 h1 Participants
Control GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsNumber of subjects with cardiac arrest or death within 24 h post infusion0 Participants
Control GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsNumber of subjects with an increase in vasopressor dose at 6 h1 Participants
Control GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsIn subjects receiving mechanical ventilation, Number of subjects with worsening of hypoxemia at 6 h1 Participants
Control GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsIn subjects on high flow oxygen therapy:worsening hypoxemia(req intubat, mechanical ventilat) at 6 h0 Participants
Control GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsNumber of subjects with new cardiac arrhythmia requiring cardioversion at 6 h1 Participants
Control GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsNumber of subjects with new ventricular tachycardia, ventricular fibrillation, or asystole at 6 h1 Participants
Control GroupNumber of Participants With Pre-Specified Infusion Associated Adverse EventsA clinical scenario consistent with transfusion incompatibility or transfusion-rel infection at 6h0 Participants
Primary

Number of Subjects With Serious Adverse Events by 31 Days After First Infusion

The number of subjects experiencing serious adverse events by 31 days after the first infusion (corresponding to 28 days after the last infusion).

Time frame: 31 days

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
UC-MSCs GroupNumber of Subjects With Serious Adverse Events by 31 Days After First Infusion2 Participants
Control GroupNumber of Subjects With Serious Adverse Events by 31 Days After First Infusion8 Participants
Comparison: The null hypothesis is the following: There is no difference in the number of subjects experiencing serious adverse events in the UC-MSC vs control group.p-value: 0.04Fisher Exact
Primary

Percentage of Participants Experiencing Serious Adverse Events (SAEs) Through Study Day 90

Safety will be reported as the percentage of participants experiencing serious adverse events through Day 90 as assessed by treating physician.

Time frame: 90 days

ArmMeasureValue (NUMBER)
UC-MSCs GroupPercentage of Participants Experiencing Serious Adverse Events (SAEs) Through Study Day 9041.67 percentage of participants
Control GroupPercentage of Participants Experiencing Serious Adverse Events (SAEs) Through Study Day 9066.67 percentage of participants
Primary

Subjects With Adverse Events and Serious Adverse Events by Severity

Total number of subjects with adverse events and serious adverse events categorized by severity.

Time frame: 90 days

Population: Subjects who experience one or more AEs or SAEs within each category are counted only once.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
UC-MSCs GroupSubjects With Adverse Events and Serious Adverse Events by SeverityMild7 Participants
UC-MSCs GroupSubjects With Adverse Events and Serious Adverse Events by SeverityModerate7 Participants
UC-MSCs GroupSubjects With Adverse Events and Serious Adverse Events by SeveritySevere5 Participants
Control GroupSubjects With Adverse Events and Serious Adverse Events by SeverityMild5 Participants
Control GroupSubjects With Adverse Events and Serious Adverse Events by SeverityModerate8 Participants
Control GroupSubjects With Adverse Events and Serious Adverse Events by SeveritySevere7 Participants
Primary

Subjects With Adverse Events by Relatedness to Treatment

Total number of subjects with adverse events categorized by relatedness to treatment by a medical professional

Time frame: 90 days

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
UC-MSCs GroupSubjects With Adverse Events by Relatedness to TreatmentUnlikely1 Participants
UC-MSCs GroupSubjects With Adverse Events by Relatedness to TreatmentProbable0 Participants
UC-MSCs GroupSubjects With Adverse Events by Relatedness to TreatmentPossible1 Participants
UC-MSCs GroupSubjects With Adverse Events by Relatedness to TreatmentDefininte0 Participants
UC-MSCs GroupSubjects With Adverse Events by Relatedness to TreatmentUnrelated8 Participants
Control GroupSubjects With Adverse Events by Relatedness to TreatmentDefininte0 Participants
Control GroupSubjects With Adverse Events by Relatedness to TreatmentUnrelated10 Participants
Control GroupSubjects With Adverse Events by Relatedness to TreatmentUnlikely4 Participants
Control GroupSubjects With Adverse Events by Relatedness to TreatmentPossible1 Participants
Control GroupSubjects With Adverse Events by Relatedness to TreatmentProbable0 Participants
Secondary

25-Hydroxy Vitamin D Levels

As assessed via serum blood samples.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6. In the control group one subject was not included in the analysis due to death before day 6.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs Group25-Hydroxy Vitamin D Levels23.21 ng/mlStandard Deviation 8.91
Control Group25-Hydroxy Vitamin D Levels27.58 ng/mlStandard Deviation 16.38
Secondary

Alanine Aminotransferase or Serum Glutamate-pyruvate Transaminase (ALT or SGPT)

The alanine aminotransferase or serum glutamate-pyruvate transaminase (ALT or SGPT) test as assessed via serum blood samples

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and 5 subjects data was not collected. In the control group one subject was not included in the analysis due to death before day 6, and 5 subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupAlanine Aminotransferase or Serum Glutamate-pyruvate Transaminase (ALT or SGPT)64.4 U/LStandard Deviation 38.43
Control GroupAlanine Aminotransferase or Serum Glutamate-pyruvate Transaminase (ALT or SGPT)65.67 U/LStandard Deviation 45.04
Secondary

Albumin

Albumin levels as assessed via serum blood samples

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and 5 subjects data was not collected. In the control group one subject was not included in the analysis due to death before day 6, and 5 subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupAlbumin2.96 g/dLStandard Deviation 0.43
Control GroupAlbumin2.73 g/dLStandard Deviation 0.45
Secondary

Alkaline Phosphatase

Alkaline phosphatase levels as assessed via serum blood samples for the Comprehensive Metabolic Panel.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and 5 subjects data was not collected. In the control group one subject was not included in the analysis due to death before day 6, and 5 subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupAlkaline Phosphatase136.2 U/LStandard Deviation 68.36
Control GroupAlkaline Phosphatase202.5 U/LStandard Deviation 219.13
Secondary

Arachidonic Acid/Eicosapentaenoic Acid (AA/EPA) Ratio

As assessed via serum blood samples on day 6 (visit 8).

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6. In the control group one subject was not included in the analysis due to death before day 6.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupArachidonic Acid/Eicosapentaenoic Acid (AA/EPA) Ratio33.6 ratio of AA to EPAStandard Deviation 12
Control GroupArachidonic Acid/Eicosapentaenoic Acid (AA/EPA) Ratio34.64 ratio of AA to EPAStandard Deviation 13.24
Secondary

Aspartate Aminotransferase or Serum Glutamic Oxaloacetic Transaminase (AST or SGOT)

The aspartate aminotransferase or serum glutamic oxaloacetic transaminase (AST or SGOT) test as assessed via serum blood samples

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and 5 subjects data was not collected. In the control group one subject was not included in the analysis due to death before day 6, and 5 subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupAspartate Aminotransferase or Serum Glutamic Oxaloacetic Transaminase (AST or SGOT)55.8 U/LStandard Deviation 23.86
Control GroupAspartate Aminotransferase or Serum Glutamic Oxaloacetic Transaminase (AST or SGOT)47 U/LStandard Deviation 32.47
Secondary

Blood Urea Nitrogen (BUN)

Blood urea nitrogen (BUN) levels as assessed via serum blood samples for the comprehensive metabolic panel.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupBlood Urea Nitrogen (BUN)48 mg/dLStandard Deviation 22.28
Control GroupBlood Urea Nitrogen (BUN)47.67 mg/dLStandard Deviation 26.97
Secondary

Calcium

Calcium levels as assessed via serum blood samples for the comprehensive metabolic panel.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupCalcium8.5 mg/dLStandard Deviation 0.58
Control GroupCalcium8.27 mg/dLStandard Deviation 0.67
Secondary

Carbon Dioxide (CO2)

Carbon Dioxide (CO2) levels as assessed via serum blood samples for the comprehensive metabolic panel.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupCarbon Dioxide (CO2)28.44 mmol/LStandard Deviation 3.75
Control GroupCarbon Dioxide (CO2)26.44 mmol/LStandard Deviation 4.61
Secondary

Chloride

Chloride levels as assessed via serum blood samples for the comprehensive metabolic panel.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupChloride101.56 mmol/LStandard Deviation 7.63
Control GroupChloride102.44 mmol/LStandard Deviation 9.04
Secondary

C-Reactive Protein Levels

As assessed via serum blood samples.

Time frame: day 6

Population: In the UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and data was missing for two subjects. In the control group one subject was not included in the analysis due to death before day 6.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupC-Reactive Protein Levels101.01 mg/LStandard Deviation 131.05
Control GroupC-Reactive Protein Levels112.55 mg/LStandard Deviation 104.7
Secondary

Creatinine

Creatinine levels as assessed via serum blood samples

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupCreatinine1.21 mg/dLStandard Deviation 0.54
Control GroupCreatinine1.24 mg/dLStandard Deviation 0.74
Secondary

D-dimer Levels

As assessed via serum blood samples.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6 and one subject data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupD-dimer Levels6.2 mcg/ml FEUStandard Deviation 11.29
Control GroupD-dimer Levels4.69 mcg/ml FEUStandard Deviation 3.38
Secondary

Glomerular Filtration Rate

Glomerular filtration rate (GFR) as assessed via serum blood samples to check how well the kidneys are working. It estimates how much blood passes through the glomeruli each minute.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupGlomerular Filtration Rate60.59 mL/min/1.73 m^2Standard Deviation 26.99
Control GroupGlomerular Filtration Rate68.67 mL/min/1.73 m^2Standard Deviation 35.4
Secondary

Glucose

Glucose levels as assessed via serum blood samples

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupGlucose153.11 mg/dLStandard Deviation 63.99
Control GroupGlucose183.89 mg/dLStandard Deviation 82.33
Secondary

Hematocrit

The percentage by volume of red cells in your blood as assessed via serum blood samples.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupHematocrit37.98 percentage of red blood cells by volumeStandard Deviation 8.32
Control GroupHematocrit36.73 percentage of red blood cells by volumeStandard Deviation 9.56
Secondary

Hemogoblin

Measures the total amount of the oxygen-carrying protein in the blood as assessed via serum blood samples.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupHemogoblin11.93 g/dLStandard Deviation 2.82
Control GroupHemogoblin11.94 g/dLStandard Deviation 3.34
Secondary

Lymphocytes

Lymphocyte count as assessed via serum blood samples

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and two subjects data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupLymphocytes1.38 10^3 cells/uLStandard Deviation 1.07
Control GroupLymphocytes0.8 10^3 cells/uLStandard Deviation 0.41
Secondary

Neutrophils

the amount of immune cells (that is one of the first cell types to travel to the site of an infection) as assessed via serum blood samples

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and two subjects data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupNeutrophils9.74 10^3 cells/uLStandard Deviation 4.27
Control GroupNeutrophils13.4 10^3 cells/uLStandard Deviation 5.95
Secondary

Number of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 14 Post First Infusion

Number of participants reporting panel reactive antibody (PRA) positivity at Day 14 post first infusion for class I and class II as assessed via serum blood samples. These antibodies can develop following a transplant. Recipients can become sensitized to certain molecules (Human Leukocyte Antigen Class I or Class II), which can affect immune responses to and rejection of potential future transplants.

Time frame: day 14

Population: In the UC-MSC group one patient was censored and died before day 6, 6 patients left the hospital before day 6 post first infusion. In the control group 4 patients died, 3 patients left the hospital and one left hospital against medical advice before day 6 post first infusion.

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 14 Post First InfusionClass IPRA Positive5 Participants
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 14 Post First InfusionClass IPRA Negative0 Participants
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 14 Post First InfusionClass IIPRA Positive4 Participants
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 14 Post First InfusionClass IIPRA Negative1 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 14 Post First InfusionClass IIPRA Negative2 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 14 Post First InfusionClass IPRA Positive3 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 14 Post First InfusionClass IIPRA Positive2 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 14 Post First InfusionClass IPRA Negative1 Participants
Comparison: The null hypothesis is the following: There is no association between PRA (class I) status and treatment group at 14 days post first infusion.p-value: 0.44Fisher Exact
Comparison: The null hypothesis is the following: There is no association between PRA (class II) status and treatment group at 14 days post first infusion.p-value: 0.5238Fisher Exact
Secondary

Number of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 3 Post First Infusion

Number of participants reporting panel reactive antibody (PRA) positivity at Day 3 post first infusion for class I and class II as assessed via serum blood samples. These antibodies can develop following a transplant. Recipients can become sensitized to certain molecules (Human Leukocyte Antigen Class I or Class II), which can affect immune responses to and rejection of potential future transplants.

Time frame: day 3 post first infusion

Population: One subject in the control group died before day 3 post first infusion.

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 3 Post First InfusionClass IPRA Positive10 Participants
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 3 Post First InfusionClass IPRA Negative2 Participants
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 3 Post First InfusionClass IIPRA Positive4 Participants
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 3 Post First InfusionClass IIPRA Negative8 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 3 Post First InfusionClass IIPRA Negative5 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 3 Post First InfusionClass IPRA Positive11 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 3 Post First InfusionClass IIPRA Positive6 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 3 Post First InfusionClass IPRA Negative0 Participants
Comparison: The null hypothesis is the following: There is no association between PRA (class I) status and treatment group at 3 days post first infusion.p-value: 0.48Fisher Exact
Comparison: The null hypothesis is the following: There is no association between PRA (class II) status and treatment group at 3 days post first infusion.p-value: 0.41Fisher Exact
Secondary

Number of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 6 Post First Infusion

Number of participants reporting panel reactive antibody (PRA) positivity at Day 6 post first infusion for class I and class II as assessed via serum blood samples. These antibodies can develop following a transplant. Recipients can become sensitized to certain molecules (Human Leukocyte Antigen Class I or Class II), which can affect immune responses to and rejection of potential future transplants.

Time frame: day 6

Population: In the UC-MSC group one patient was censored and died before day 6 and one patient recovered before day 6 and left the hospital. In the control group on patient died before day 6 post first infusion.

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 6 Post First InfusionClass IPRA Positive9 Participants
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 6 Post First InfusionClass IPRA Negative1 Participants
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 6 Post First InfusionClass IIPRA Positive5 Participants
UC-MSCs GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 6 Post First InfusionClass IIPRA Negative5 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 6 Post First InfusionClass IIPRA Negative6 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 6 Post First InfusionClass IPRA Positive9 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 6 Post First InfusionClass IIPRA Positive5 Participants
Control GroupNumber of Participants Reporting Panel Reactive Antibody (PRA) Positivity at Day 6 Post First InfusionClass IPRA Negative2 Participants
Comparison: The null hypothesis is the following: There is no association between PRA (class I) status and treatment group at 6 days post first infusion.p-value: 1Fisher Exact
Comparison: The null hypothesis is the following: There is no association between PRA (Class II) status and treatment group at 6 days post first infusion.p-value: 1Fisher Exact
Secondary

Number of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgG

Number of participants with positive, negative, or borderline SARS-CoV-2 Immunoglobulin M (IgM)/Immunoglobulin G (IgG) serology from serum blood samples.

Time frame: day 14 post first infusion

Population: These analyses were implemented in a protocol version that did not apply to 2 patients of the UC-MSC treatment group and 3 patients of the control group. In the UC-MSC group one patient was censored and died before day 6, 4 patients left the hospital before day 6 post first infusion and in one patient blood was not drawn. In the control group 3 patients died, 3 patients left the hospital and one left hospital against medical advice before day 6 post first infusion.

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
UC-MSCs GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgMPositive2 Participants
UC-MSCs GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgMNegative1 Participants
UC-MSCs GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgMBorderline1 Participants
UC-MSCs GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgGPositive4 Participants
UC-MSCs GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgGNegative0 Participants
UC-MSCs GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgGBorderline0 Participants
Control GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgGNegative0 Participants
Control GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgMPositive2 Participants
Control GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgGPositive2 Participants
Control GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgMNegative0 Participants
Control GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgGBorderline0 Participants
Control GroupNumber of Participants With Positive, Negative, or Borderline Serology Testing for SARS-CoV-2 IgM/IgGIgMBorderline0 Participants
Secondary

Oxygenation Index (OI)

Measure of the fraction of inspired oxygen (FiO2) and its usage within the body during intensive care, measured using fNIRS (Functional Near Infrared Spectroscopy). The calculation for Oxygenation index is ((FIO2 \* Mean airway pressure)/partial pressure of oxygen).

Time frame: day 6

Population: Oxidation Index is only measured and calculated in ventilated patients, therefore 3 patients in the UC-MSC group were included and 3 patients in the control group were included.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupOxygenation Index (OI)9.62 IndexStandard Deviation 1.43
Control GroupOxygenation Index (OI)12.74 IndexStandard Deviation 5.21
Secondary

Platelets Count

As assessed via serum blood samples.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupPlatelets Count342 10^3 cells/uLStandard Deviation 136.33
Control GroupPlatelets Count397.89 10^3 cells/uLStandard Deviation 135.59
Secondary

Positive End-Expiratory Pressure (PEEP) and Plateau Pressure (Pplat)

Measuring the respiratory mechanics; positive end-expiratory pressure (PEEP) and plateau pressure (Pplat) in ventilated patients visit 8 (day 6)

Time frame: day 6

Population: PEEP and Plateau pressure are only measured in ventilated patients, therefore 3 patients in the UC-MSC group were included and 3 patients in the control group were included.

ArmMeasureGroupValue (MEAN)Dispersion
UC-MSCs GroupPositive End-Expiratory Pressure (PEEP) and Plateau Pressure (Pplat)PEEP9.73 cm H2OStandard Deviation 3.72
UC-MSCs GroupPositive End-Expiratory Pressure (PEEP) and Plateau Pressure (Pplat)Plateau Pressure28.67 cm H2OStandard Deviation 9.61
Control GroupPositive End-Expiratory Pressure (PEEP) and Plateau Pressure (Pplat)PEEP11.67 cm H2OStandard Deviation 1.53
Control GroupPositive End-Expiratory Pressure (PEEP) and Plateau Pressure (Pplat)Plateau Pressure24 cm H2OStandard Deviation 2.83
Secondary

Potassium

Potassium levels as assessed via serum blood samples.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupPotassium4.25 mmol/LStandard Deviation 0.71
Control GroupPotassium4.37 mmol/LStandard Deviation 0.73
Secondary

Respiratory Rate and Oxygenation Index (ROX Index)

Respiratory Rate-Oxygenation (ROX) index is defined as the ratio of oxygen saturation as measured by pulse oximetry (SpO2)/ Fraction of inspired oxygen (FiO2) to respiratory rate. This index can be used in the assessment of disease progression and the risk of intubation in COVID-19 patients with pneumonia.

Time frame: day 6

Population: ROX index was only measured for patients receiving HFNC and/or not intubated patients. Three patients were ventilated in the UC-MSC group, one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, two patients data was not collected. In the control group one subject was not included in the analysis due to death before day 6, three patients were ventilated, and one patient data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupRespiratory Rate and Oxygenation Index (ROX Index)9.57 IndexStandard Deviation 5.23
Control GroupRespiratory Rate and Oxygenation Index (ROX Index)7.44 IndexStandard Deviation 2.9
Secondary

Sequential Organ Failure Assessment (SOFA) Scores

Sequential Organ Failure Assessment (SOFA) Scores is used to track a person's risk status during stay in the Intensive Care Unit (ICU). The score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal, and neurological systems. Each organ system is assigned a point value from a minimum of 0 (normal) to a maximum of 4 (high degree of dysfunction/failure). The total score corresponds to the sum of the six different scores of the organ systems. In total, the minimum SOFA score is 0 (normal) and the maximum SOFA score is 24 (highest degree dysfunction/failure).

Time frame: Day 6

Population: In the UC-MSC treatment group one subject was not included in the analysis due to death and 2 subjects were not included due to discharge on day 6. In the control group one subject was not included in the analysis due to death before day 6.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupSequential Organ Failure Assessment (SOFA) Scores6.56 score on a scaleStandard Deviation 2.7
Control GroupSequential Organ Failure Assessment (SOFA) Scores6.82 score on a scaleStandard Deviation 2.36
Secondary

Smell Identification Test (SIT) Scores

SIT measures the participant's sense of smell. SIT has a total score ranging from 0 to 40 with the higher the score indicating a more normal sense of smell

Time frame: 90 days

Population: No participants in the study were able to complete the Smell Evaluation Test due to extenuating circumstances related to the COVID-19 pandemic.

Secondary

Sodium

Sodium levels as assessed by serum blood samples.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupSodium141.22 mmol/LStandard Deviation 6.24
Control GroupSodium141 mmol/LStandard Deviation 9.57
Secondary

Soluble Tumor Necrosis Factor Receptor 2 (sTNFR2)

Analysis of soluble tumor necrosis factor receptor 2 (sTNFR2) in peripheral blood plasma

Time frame: day 6

Population: In the UC-MSC treatment group one subject was not included in the analysis due to failed intubation. In the control group one subject was not included in the analysis because of death before day 6 blood draw and data was unavailable for two patients.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupSoluble Tumor Necrosis Factor Receptor 2 (sTNFR2)26609.09 pg/mLStandard Deviation 3071.96
Control GroupSoluble Tumor Necrosis Factor Receptor 2 (sTNFR2)23111.11 pg/mLStandard Deviation 3086.03
p-value: 0.02195% CI: [-6404.7, -591.2]t-test, 2 sided
Secondary

Survival at 31 Days Post First Infusion

Number of participants that are alive at 31 days post first infusion follow up corresponding to 28 day post second infusion.

Time frame: 31 Days

Population: One subject in the UC-MSC Group was not included in the data analysis due to failed intubation.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
UC-MSCs GroupSurvival at 31 Days Post First Infusion10 Participants
Control GroupSurvival at 31 Days Post First Infusion5 Participants
Secondary

Survival at 60 Days Post First Infusion

Number of participants alive at 60 days post first infusion follow up.

Time frame: 60 days

Population: A subject was censored due to failed intubation in the UC-MSC group.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
UC-MSCs GroupSurvival at 60 Days Post First Infusion9 Participants
Control GroupSurvival at 60 Days Post First Infusion5 Participants
Secondary

Time to Recovery

Time to discharge or, if the subject was hospitalized, no longer requiring supplemental oxygen and no longer requiring COVID-19-related medical care by 31 days. The numbers represent days at which 25%, 50%, 75% subjects within the treatment group had recovered.

Time frame: 31 days

ArmMeasureGroupValue (NUMBER)
UC-MSCs GroupTime to RecoveryDays by which 75% of subjects were recovered23 days
UC-MSCs GroupTime to RecoveryDays by which 50% of subjects were recovered15 days
UC-MSCs GroupTime to RecoveryDays by which 25% of subjects were recovered8 days
Control GroupTime to RecoveryDays by which 75% of subjects were recoveredNA days
Control GroupTime to RecoveryDays by which 50% of subjects were recoveredNA days
Control GroupTime to RecoveryDays by which 25% of subjects were recovered12 days
Comparison: The null hypothesis is the following: There is no difference in Time to Recovery up to 31 days post infusion between the UC-MSC group and control group. Time to recovery was estimated in each group with Kaplan-Meier survival estimates. Log-rank tests were used to compare hazards between groups.p-value: 0.030795% CI: [0.088, 0.948]Log Rank
Secondary

Total Bilirubin

Bilirubin levels as assessed via serum blood samples for the comprehensive metabolic panel.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and 5 subjects data was not collected. In the control group one subject was not included in the analysis due to death before day 6, and 5 subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupTotal Bilirubin0.88 mg/dLStandard Deviation 0.46
Control GroupTotal Bilirubin0.77 mg/dLStandard Deviation 0.29
Secondary

Total Protein

Total protein as assessed via serum blood samples as a part of the comprehensive metabolic panel (CMP). It is a measurement of the sum of albumin and globulins.

Time frame: Day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and 5 subjects data was not collected. In the control group one subject was not included in the analysis due to death before day 6, and 5 subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupTotal Protein5.88 g/dLStandard Deviation 0.54
Control GroupTotal Protein5.8 g/dLStandard Deviation 1.06
Secondary

Tumor Necrosis Factor-alpha (TNFα)

Analysis of TNFα in peripheral blood plasma

Time frame: day 6

Population: In the UC-MSC treatment group one subject was not included in the analysis due to failed intubation. In the control group one subject was not included in the analysis because of death before day 6 blood draw.

ArmMeasureValue (MEDIAN)
UC-MSCs GroupTumor Necrosis Factor-alpha (TNFα)349 pg/mL
Control GroupTumor Necrosis Factor-alpha (TNFα)451 pg/mL
p-value: 0.0356Wilcoxon (Mann-Whitney)
Secondary

Tumor Necrosis Factor-beta (TNFβ)

Analysis of TNFβ in peripheral blood plasma

Time frame: day 6

Population: In the UC-MSC treatment group one subject was not included in the analysis due to failed intubation. In the control group one subject was not included in the analysis because of death before day 6 blood draw.

ArmMeasureValue (MEDIAN)
UC-MSCs GroupTumor Necrosis Factor-beta (TNFβ)829 pg/mL
Control GroupTumor Necrosis Factor-beta (TNFβ)1540 pg/mL
p-value: 0.0215Wilcoxon (Mann-Whitney)
Secondary

Ventilator-Free Days Throughout 28 Days Post Second Infusion

Number of days participants were off ventilators during 28 days post second infusion.

Time frame: 28 days post second infusion

Population: In the UC-MSC treatment group one subject was not included in the analysis due to censoring and another subject was not included due to loss to follow-up. In the control group one subject was not included in the analysis due to discharge against medical advice.

ArmMeasureValue (MEDIAN)
UC-MSCs GroupVentilator-Free Days Throughout 28 Days Post Second Infusion28 days
Control GroupVentilator-Free Days Throughout 28 Days Post Second Infusion0 days
Comparison: Null Hypothesis: The center of the distributions of ventilator free days are equal in the UC-MSC and control group.p-value: 0.0563Wilcoxon (Mann-Whitney)
Secondary

Ventilator-Free Days Throughout 90 Days

Number of days participants were off ventilators within up to 90 days of hospitalization.

Time frame: 90 days or hospital discharge, whichever is earlier

Population: In the UC-MSC treatment group one subject was not included in the analysis due to censoring and another subject was not included due to loss to follow-up. In the control group one subject was not included in the analysis due to discharge against medical advice.

ArmMeasureValue (MEDIAN)
UC-MSCs GroupVentilator-Free Days Throughout 90 Days90 days
Control GroupVentilator-Free Days Throughout 90 Days0 days
Comparison: Null Hypothesis: The center of the distributions of ventilator free days are equal in the UC-MSC and control group.p-value: 0.0563Wilcoxon (Mann-Whitney)
Secondary

Viral Load by SARS-CoV-2 RT-PCR

Viral load as assessed in blood plasma for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) via Reverse Transcriptase Polymerase Chain Reaction (RT-PCR).

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6. In the control group one subject was not included in the analysis due to death before day 6.

ArmMeasureValue (MEDIAN)
UC-MSCs GroupViral Load by SARS-CoV-2 RT-PCR0 RNA copies/mL
Control GroupViral Load by SARS-CoV-2 RT-PCR0 RNA copies/mL
Secondary

White Blood Cell Count (WBC)

As assessed via serum blood samples.

Time frame: day 6

Population: The UC-MSC treatment group one subject was not included in the analysis due to death, one subject was not included due to discharge on day 6, and one subject data was not collected. In the control group one subject was not included in the analysis due to death before day 6, two subjects data was not collected.

ArmMeasureValue (MEAN)Dispersion
UC-MSCs GroupWhite Blood Cell Count (WBC)13.43 10^3 cells/uLStandard Deviation 4.62
Control GroupWhite Blood Cell Count (WBC)15.53 10^3 cells/uLStandard Deviation 5.6

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026