
As we cautiously transition to a "post-COVID-19 era," the urgent need for therapies targeting severe pneumonia and immune dysregulation becomes evident. While corticosteroids and some immunotherapies show promise, critically ill patients lack effective treatments. Mesenchymal stem/stromal cells (MSCs) and their extracellular vesicles (MSC-EVs) are under scrutiny. A recent phase 2 clinical trial testing MSC-EVs in severe COVID-19 respiratory failure found no significant differences in primary and secondary endpoints, but a mortality difference in a subset warrants cautious interpretation. The study marks progress in MSC-EV clinical translation, emphasizing safety and feasibility. Future studies must address stratification, EV characterization, and broader clinical effects.
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