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Fig. 2 | Stem Cell Research & Therapy

Fig. 2

From: Mesenchymal stem cells derived from perinatal tissues for treatment of critically ill COVID-19-induced ARDS patients: a case series

Fig. 2

Chest computed tomography (CT) images in three survivors. a Patient #2: First row is prior to cell infusion. Note the extensive mixed ground glass opacities, crazy paving appearance, vascular dilatation, consolidations with peripheral subpleural dominancy, and bilateral mild pleural effusion. The CT severity score for all five lobes was 24. The second row shows CT images 1 day after the third dose of cell therapy. There is a decrease in extension of consolidations associated with band-like opacities and traction bronchiectasis are evident. CT severity score for all five lobes was 18. The third row shows near complete resolution of opacities and subpleural bands without residual fibrosis 50 days after MSC therapy. The CT severity score for all five lobes was 2. The percentage of lung involvement in each image of the first, second, and third columns was assessed at pretreatment, 1 day after the third post-cell therapy, and after 50 days of treatment, respectively, as follows. First column: about 60%, 25%, and 0%; second column: about 75%, 30%, and 0%; and third column: about 90%, 50%, and 2%. b Patient #3: First row shows chest CT images before cell therapy. Note the patchy areas of ground glass opacity and consolidations in the subpleural regions of the lungs. The CT severity score for all five lobes was 16. The second row shows a significant reduction in the extension of lung involvement 12 days after the third dose of cell therapy. Most consolidations had resolved completely with only band-like opacities and mild tiny residual ground glass opacities present. The CT severity score for all five lobes was 8. The percentage of lung involvement in single images from the first, second, and third columns was assessed at pretreatment and 12 days after the third cell therapy, respectively, as follows. First column: about 15% and 5%; second column: about 35% and 15%; and third column: about 20% and 3%. c Patient #8: Axial CT scan images from the base of the lung before cell therapy. The left image shows peripheral subpleural consolidations and ground glass opacity. At the same level, the right image shows a significant decrease in consolidations 12 days after cell therapy; however, the patient developed bilateral pleural effusion due to acute renal failure during the course of the disease. The CT severity score for all five lobes at the initial lung CT scan was 24, which decreased to 13 at 12 days after cell therapy. The percentage of lung involvement in the pretreatment image was about 60%, which decreased to 20% in the post-treatment image. In all images, different patterns of lung involvement have the following annotations: crazy paving appearance (black boxes), consolidation (black stars), pure ground glass opacity (solid white arrows), vascular dilatation (solid white arrows), traction bronchiectasis (solid black arrows), subpleural band (dashed white arrows), architectural distortion (white boxes), and pleural effusion (dashed black arrows)

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