When Eli Beer arrived at the UHealth Tower in March, he suspected he had contracted COVID-19 during his travels. However, he figured his recovery would be quick and that his symptoms wouldn’t get any worse. He was wrong.
Three days after being admitted to the hospital’s Intensive Care Unit with a diagnosis of “a very bad pneumonia,” Beer was put into a medically induced coma before being intubated. Told he had a 50-50 chance of surviving COVID-19, he called his wife and five children in Israel and then phoned his right-hand man at United Hatzalah, a volunteer first-response organization in Israel that he founded. As a medic, he knew the seriousness of his deteriorating condition.
“The day they intubated me I couldn’t breathe very well,” he recalls. “I thought I was making my last calls and that I wasn’t going to come out of it.”
He remained in this medically induced coma for 18 days, but shortly after he was extubated he again took a turn for the worse: bacteria had invaded his lungs. He was re-intubated, this time for 12 days. Beer, however, was fortunate to receive an experimental treatment that many physician-scientists consider very promising in the fight against the novel coronavirus.
He became the first patient in Miami to be infused with mesenchymal stem cells (MSC), an experimental therapy doctors are using on a case-by-case basis to treat the devastating inflammation caused by COVID-19. On April 5 — two days before Sixto Alejandro Arias, M.D., an interventional pulmonologist with the University of Miami Health System, gave Beer the intravenous infusion of the investigational study treatment — the U.S. Food and Drug Administration approved MSC treatment for Beer under the agency’s expanded access compassionate use.
Within days, Beer had recovered enough to be released and fly home to his family in Israel.
Dr. Arias calls the stem cells, “a helpful therapy,” but points out that he doesn’t know how much the MSCs improved his condition.
Beer, 46, wasn’t the only one treated with an MSC infusion from UHealth’s Interdisciplinary Stem Cell Institute (ISCI) manufacturing lab, which harvests and cultures these stem cells. UM also has sent these MSCs to clinicians in Maryland. The majority of the patients treated there have recovered despite having advanced disease due to the COVID-19.
MSC infusions have been administered as an experimental product to treat other diseases, including interstitial lung disease, cardiac issues, rheumatoid arthritis and diabetes. Like Dr. Arias, Dr. Joshua Hare, founding director of ISCI, cautions that this kind of therapy still has to undergo the rigorous process of clinical trials and an approval by the FDA before it can be used by doctors to treat these patients.
Nevertheless, recent historical data, Dr. Hare adds, show an 80 to 90% recovery rate for COVID-19 patients who were intubated with pneumonia and treated with MSC cells. “Can we conclude their recovery is due to the infusion? No. These patients also received other treatments. But there’s a lot of enthusiasm because of previous success, and this has led to the initiation of multiple phase 1, 2, and 3 placebo-controlled clinical trials around the United States.”
To learn more about how MSC therapy helps COVID-19 patients, Dr. Hare and his team have been approved for a Phase I clinical trial. This will involve COVID-19 positive patients in early stage respiratory distress. Fourteen will receive an MSC infusion and seven a placebo. Candidates will be eligible for the trial within 72 hours of entering the hospital. The ISCI is uniquely positioned to do this kind of study because it has the laboratory resources, infrastructure and scientific expertise already in place. ISCI currently has several phase I/2 clinical trials that look into MSC treatment for cardiac patients.
While MSC cells can be obtained from both the lining of the umbilical cord and bone marrow, Dr. Hare says researchers will be using the umbilical cord cells exclusively for the trial. “They’re more easily available,” he explains.
Doctors already know that MSCs can reduce inflammation caused by other diseases.
They believe an infusion works the same way in COVID-19 patients, decreasing the massive cytokine storm triggered by the virus. A cytokine storm occurs when the immune system goes haywire, attacking both healthy cells along with the invading virus. This overreaction, in turn, precipitates acute respiratory distress syndrome (ARDS), a life-threatening condition in which fluid leaks into the lungs, making breathing practically impossible.
For Beer, his recovery is nothing short of a miracle. Back at home he continues his respiratory therapy and special physical exercises. He says he owes his life to both the many people who prayed for him and the physicians and nurses who watched over him when he was so far from home. He plans to visit the Western Wall to personally pray for these healthcare heroes.
“I was treated like royalty,” he says. “I have tremendous admiration for these doctors and everyone working in hospitals. They all deserve our gratitude.”
But he also has a word of warning for those who shrug off the impact of the coronavirus. He was “a regular healthy guy” with no underlying conditions. He didn’t smoke and had never taken drugs. “It was a big shock for me [to be so sick],” he says. “I want people to take this very seriously. This is like 100 times worse than any flu.”
Ana Veciana-Suarez, Guest Columnist
Ana is a regular contributor to the University of Miami Health System. She is a renowned journalist and author, who has worked at The Miami Herald, The Miami News, and The Palm Beach Post. Visit her website at anavecianasuarez.com or follow @AnaVeciana on Twitter.
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