Do stem cells for Long COVID make sense including for associated brain issues?
Two readers of The Niche asked me this question recently.
Let’s discuss it.
Stem cells for Long COVID worth trying?
What is Long COVID? A sizable fraction of people who get COVID-19 never fully recover. They may have symptoms like fatigue, brain fog, and other issues for months. Sometimes years. This is Long COVID. It may be due to an ongoing immune system response to an infection that doesn’t fully resolve in all tissues.
It’s not surprising that people have questions about Long COVID since it is relatively common.
In the early days of the pandemic I got some queries about stem cells for COVID, meaning acute COVID. While I’m not a physician, as a stem cell researcher I have followed the possibility of using stem cells for acute COVID. So far, the answer is largely not encouraging.
The question of cell therapy for Long COVID is somewhat different, but here too the data just are not convincing. Not yet.
I know that many people with Long COVID feel that today’s medicine doesn’t seem to help them so they are looking for other options. Here’s an adapted version of more that I told the readers about stem cells for Long COVID.
Do IV stem cells get into the brain?
One of the challenges with potential cell treatments for brain issues related to COVID is that most stem cells are administered IV and don’t even get into the brain.
The hypothesis pitched by unproven clinics and researchers alike is that various kinds of cells or cellular exosome therapy could reduce the inflammation associated with COVID. This in turn would reduce symptoms and speed recovery. One of the challenges with this idea is that steroids can reduce inflammation and can help COVID more simply than cells. While steroids have risks too, cell therapies might be riskier and have more unknowns.
I don’t believe there is good evidence for cells working long-term for COVID.
Injections into the CNS pose risks.
Other clinics give stem cells into the spine, which then potentially can make their way to the brain.
This seems like a much riskier way to go. and again there just aren’t good data for this being helpful.
Probably because the number of cells getting to the brain might still be very low.
Note that the FDA, while okaying research on cells for COVID, has not approved any cellular therapy for Long COVID or the regular version.
Stem cells for long COVID: unmatched donor cells vs your own.
Another challenge is that it seems like every COVID patient can be very different and there’s no way to predict who might benefit from cell therapy and who probably won’t.
Also keep in mind that some clinics use other people’s cells and, as you noted, many of these firms do not do matching. Your immune system will often destroy other people’s cells. Even so, these cells, while they are still around, could pose unique risks like weird immune system reactions. I wouldn’t want such cells put into my brain.
Using your own cells is on average probably safer but I’m still not convinced they could help Long COVID and still come with risks. One of the problems is that stem cell clinics are not always careful with sterility, so some patients have gotten serious infections.
Note that I’m not a doctor so I do not give medical advice. These are just my impressions as a stem cell researcher who has been following stem cell clinics for a long time.
Looking ahead
Have you seen a neurologist? Maybe one who specializes in Long COVID? That would be my advice.
I wish I had more encouraging news on this. There is still hope that more research could pinpoint a benefit to using cells in some Long COVID patients but it’s not a sure thing and definitely not ready for prime time right now. Unfortunately, many clinics across the U.S. nonetheless sell various supposed cell or exosome therapies for Long COVID. It’s a big problem.
References
- For context, these days I get one or two emails a week with various questions about stem cells from people who read The Niche. This has added up to around 500 hundred questions over the 14 years of this site’s existence.
- Yale website on brain fog associated with Long COVID.
- Paper on unproven stem cell clinics marketing for Long COVID relief.
Dear Paul,
How about intranasal delivery?
Interesting question. Stuff that is inhaled through the nose including in some cases cells can get into the brain. It appears to be kind of hit or miss as to whether this method gets cells in though and how many. It might depend on the specifics of how its done, the buffer used to suspend the cells, and the integrity of the nasal/olfactory epithelium in each patient. Regardless, there could be big risks should living cells get into your brain this way. Let’s assume 10,000,000 cells are snorted, 10,000 get into the brain, and 1,000 survive for at least a period of a few months once there. We have no control over what those 1,000 cells do, where they might go, etc. Other material in the nasal preparation like chemicals would get into the brain too, posing possible risks. There is legit research on intranasal delivery of cells but it shouldn’t be something that clinics sell. Yet it is being sold. https://ipscell.com/2021/08/clinics-turning-to-potentially-dangerous-intranasal-stem-cell-delivery/
The molecules released by stem cells cetainly make much sense as a therapeutic candidate for Long Covid.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8437473/
I’m not saying that the molecules don’t make sense in theory. I’m saying we are not at a point where anyone should be selling this approach at a clinic. A lot of hypotheses seem to make perfect sense but end up not working out or, for clinical approaches, end up not being safe. There’s no FDA approval despite the FDA OK’ing many INDs in this area.