stem cell treatment given to covid patients shows promising results
5 minute read
sharon charlebois does not remember much about her time in intensive care with severe covid in 2021, but she is certain about one thing: her participation in a clinical trial saved her life.
jean levac
/
postmedia
in january 2021, at the height of the pandemic, sharon charlebois spent three weeks at the civic hospital battling a life-threatening case of covid-19.
the kanata woman had not been feeling well after christmas and tested positive for the coronavirus disease. at first her symptoms seemed mild, but her condition quickly deteriorated and she began struggling to breathe.
on jan. 3, her husband called an ambulance that rushed her to the civic campus of the ottawa hospital. she was admitted to the intensive care unit with dangerously low oxygen levels and was given 100 per cent oxygen. doctors warned she was at a critical period and might need to be placed on a ventilator.
when they asked charlebois whether she wanted to be resuscitated, she was confused.
“i must have been quite out of it because i remember thinking, ‘why are you asking me this?’ dying isn’t something you usually consider.”
charlebois, who is now 78, was suffering from the most severe complication in patients with covid-19: acute respiratory distress syndrome (ards). the syndrome, which can also be related to sepsis, severe pneumonia and other illnesses, is an immune reaction to infection or trauma, which causes hyper inflammation, filling the lung’s air sacs with fluid. treatments are limited and it is frequently fatal. in the early days of the pandemic, the mortality rate in covid-19 patients with ards was more than 50 per cent.
“thank god i did it,” said sharon charlebois, looking back on her decision to be part of a clinical trial involving intravenous mesenchymal stem cell (mscs) therapy.
jean levac
/
postmedia
as the pandemic began to fill icus with extremely sick patients, scientists at the ottawa hospital rushed to develop an experimental stem cell treatment to modulate patients’ immune response to covid-19. not long after she was admitted to hospital, charlebois was asked whether she would take part in the clinical trial involving intravenous mesenchymal stem cell (mscs) therapy, which can promote healing by harnessing the body’s ability to heal and repair itself.
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family members encouraged her, so she said yes. she hoped the research would help others.
“i didn’t want anyone else to go through what i went through,” she said.
five years later, charlebois’ memories of the period remain fragmented, but she is convinced of one thing: the experimental stem cell treatment developed by ottawa scientists helped save her life. she is completely recovered from ards.
“thank god i did it.”
the precise impact of the treatment on charlebois’ recovery cannot be fully known, but the research showed promise as a treatment for ards. patients who received treatment with mscs showed about 40 per cent improvement over those who did not.
and, tellingly, patients in the blinded trial who received mscs reported a significant improvement in their health six months later compared to those who did not. (patients only learned later which arm of the trial they had been in).
dr. duncan stewart, seen in a file photo, said a 40 per cent improvement in patients who were given the stem cell treatment “is not trivial.’
trevor lush
/
the ottawa hospital
ottawa hospital researchers had previous experience working with mscs to treat patients with septic shock, which also causes the body’s immune system to go into overdrive. scientists at the hospital were among the first in the world to demonstrate the ability of the stem cells to modulate the immune system in cases of hyper inflammation — to reprogram a patient’s immune system.
building on that research, they rushed to get a clinical trial underway as the covid-19 pandemic began to fill intensive care units with extremely sick patients, some of them suffering from covid-related ards.
the research began in record time, aided by health canada’s rapid review of pandemic-related clinical trials. meanwhile, many research projects at the ottawa hospital research institute and around the world had shut down due to the pandemic and scientists were eager to contribute to pandemic research. researchers were also able to create msc therapy for severe covid-19 associated ards onsite at the hospital’s biotherapeutics manufacturing centre, which allowed a quicker launch.
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the volume of patients in the early months of the pandemic also allowed the research to begin quickly.
“we started working on this right away,” said dr. duncan stewart, a senior scientist at the ottawa hospital and professor at university of ottawa. he and his colleagues at the hospital, shane english and dean fergusson, launched the research, first with a small phase 1 trial to test safety and later with a larger phase 2 trial to better understand its efficacy and potential impact.
“it was really clear that this was an opportunity to try to use some of the knowledge we had and some of the expertise to try to hopefully improve the outcome of patients with this severe disease,” stewart said.
phase 2 of the clinical trial had to be stopped early due to fewer cases of covid-19-associated ards after vaccines were introduced, but the information gained from the trial has been valuable and opens the door to further research and possible applications of the treatment beyond covid-19.
the results were promising, notably a 40 per cent improvement (including lower mortality rates, more oxygen-free days and fewer days on ventilators) in patients who were given the stem cell treatment.
“a 40 per cent improvement is not trivial. that is a major improvement,” stewart said.
patients who received mscs as part of the research also had a full recovery in severely depressed white blood cell counts. low white blood cell counts are a predictor of poor outcomes in ards.
other researchers have also studied the use of mscs to treat severe covid-19. some also showed positive results, but the biggest trials were resoundingly negative, stewart noted.
that raises questions about what effect mass producing or freezing the cells has on their efficacy or whether there is another means of producing msc-related therapies that are effective.
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the stem cell treatment used in the trial was fresh and had never been frozen or mass produced, stewart said. the therapy could be started again “on a dime” in another pandemic situation, said fergusson, who is deputy scientific director, clinical research and senior scientist at the ottawa hospital.
the early days of the pandemic were terrifying for patients, health workers and scientists, stewart noted. “it was a really scary time.”
that made it all the more gratifying to see the positive results of the research.
charlebois, meanwhile, recommends anyone say yes to clinical trial treatments that might help them or other patients.
her recovery hasn’t always been easy — she struggled with flashbacks for a while after returning home from the hospital — but it has been steady and fully successful. and she has not missed a covid-19 vaccine.
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