COVID-19 is the defining global crisis of our time. Secondary complications such as urinary tract infections and sepsis worsen the already established health and social problems. Methods: We characterized the features and outcomes of COVID-19 patients suffering from secondary sepsis and urinary tract infection.
An observational and analytical study was conducted within the SENTAD-COVID Study clinical trial framework at the Abu Dhabi Stem Cells Center. COVID-19 patients in group A received a jet-nebulization therapy with autologous stem cells cocktail as an add-on to the standard care. In contrast, group B as controls only received the COVID-19 standard treatment.
We analyzed the culture samples, antimicrobial agents, and the therapy’s efficacy on patient outcomes. Results: A significant difference between the groups was found in the urinary infection incidence (p=0.020). Patients in group A showed a lower tendency to sepsis than group B (7% vs. 21%), hazard ratio=0.35 (95% confidence interval: 0.13-0.91), p=0.0175. The number needed to treat=7.3 was calculated and Candida albicans was the most frequent agent causing sepsis and urinary infections.
The massive use of broad-spectrum antimicrobials was striking. Conclusion: We found a protective factor of stem cells against secondary infection in COVID-19 cases in terms of sepsis and urinary infections.
The suggested immunomodulatory effect of stem cells offers a therapeutic strategy to manage the disease and avoid several complications. However, antimicrobial agents can lead to increased opportunistic infections, so a rational use of these treatments must be considered.
Introduction
COVID-19 is the most significant global crisis of our time, and
worldwide precautionary measures are taken to control the spread [1].
Sepsis and septic shock contribute to the cytokine storm syndrome causing
a high mortality rate (60-90%) [2] and immune-mediated kidney damage
[2,3], crucial to prevent this occurrence. Studies showed a sharp increase
in Methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas,
and Candida species infectious rates among the Intensive Care Unit (ICU)
COVID-19 patients, indicating that secondary infections may affect the
prognosis and subsequent treatment of these patients [4].
Strategies have been proposed to apply stem cells therapy to
regulate inflammation and prevent or mitigate cytokine storms, taking into
consideration their immunomodulatory potential by paracrine stimulation in sepsis and chronic conditions [5].
The Abu Dhabi Stem Cell Centre (ADSCC) developed a treatment
for COVID-19 («SENTAD COVID Study» clinical trial) using an autologous
Peripheral Blood Non-hematopoietic Enriched Stem Cell Cocktail (PBNHESC-C) [6].
This article analyzes the incidence of sepsis and Urinary Tract Infection
(UTI) and related pathogens compared to the rest of the germs causing
sepsis in the two study groups after receiving treatment or being recruited
as controls.
Materials and Methods
Within the framework of the SENTAD-COVID Study clinical trial [7]
we performed a multicenter, prospective, and analytical study to determine
the sepsis and UTI incidence among patients during the intervention in
April of 2020. Four different public hospitals from the Emirate of Abu Dhabi
participated: Sheikh Khalifa Medical City, Al Rahba Hospital, Al Mafraq
Hospital, and Al Ain Hospital, all administered by the Abu Dhabi Health
Services Company.
In the main study, a total of 139 patients were divided into two groups:
- Group A (Experimental) COVID-19 standard care plus nebulization
with PBNHESC (n=69) - Group B (No intervention) COVID-19 standard care (n=70).
The same inclusion and exclusion criteria of the SENTAD-COVID Study, a clinical trial retrospectively registered July 16, 2020 (ClinicalTrials.gov
Identifier: NCT04473170), were applied for recruitment and aleatorization,
so adults (≥ 18 years old) of both sexes were included [7].
Download here
Comments are closed