Mesenchymal stromal cells as potential immunomodulatory players in severe acute respiratory distress syndrome induced by SARS-CoV-2 infection

Table 1 Most common therapeutic compounds used for the treatment of coronavirus disease-19

	Agents	Mechanism of action	Approval
Antimalarial agent	Chloroquine/hydroxychloroquine	Inhibition of RNA-dependent RNA polymerase, Increase of endosomal and lysosomal pH	FDA approved (under investigation for COVID-19)
Antiviral agent	Ribavirin	Inducing mutations in RNA-dependent replication in RNA viruses, stop viral RNA synthesis	FDA approved (under investigation for COVID-19)
	Nelfinavir	Inhibitor of viral proteases	FDA approved (under investigation for COVID-19)
	Remdesivir	Inhibition of viral RNA-dependent RNA polymerase and proofreading	FDA approved (for COVID-19)
Anti-rheumatic agent	Baricitinib/ruxolitinib	JAK inhibitor/suppression of immune cells	Clinical Trial phase III
Monoclonal antibody	Tocilizumab	Humanized monoclonal antibody against the interleukin-6 receptor (IL-6R) and IL-6	FDA approved (under investigation for COVID-19)
	Anakinra	Humanized monoclonal antibody against IL-1R	FDA approved (under investigation for COVID-19)
Vaccination	Ad5-nCoV	Recombinant adenovirus type 5	Clinical Trials Phase II
	ChAdOx1 nCoV-19	Adenovirus vector	Clinical Trials Phase I-II
	INO-4800	DNA plasmid delivered by electroporation	Clinical Trials Phase I-II
	NVX-CoV2373	Recombinant S protein of SARS-CoV-2	Clinical Trial Phase I
	LV-SMENP-DC	Minigene vaccination in combination with modified DCs	Clinical Trial Phase I
Human antibodies	Convalescent plasma	Plasma enriched with antibodies specific to SARS-CoV-2, derived from convalescent patients	Clinical Trials Phase I
Stem cells	MSCs and derivatives (exosomes)	Suppression of the overactivated immune response through cell-cell contact and secretion of soluble factors	Clinical Trials Phase I

COVID-19: Coronavirus disease-19; MSCs: Mesenchymal stromal cells; SARS-CoV-2: Severe acute respiratory syndrome coronavirus-2; DCs: Dendritic cells; FDA: Food and Drug Administration.