The immediate concern for the Covid-19 pandemic is naturally the fate of patients suffering infection. But the disease may have long term consequences for the health of some who survive the initial infection. Covid-19 is primarily associated with damage to the lungs and respiratory distress, and there are increasing reports that some patients who recover from the viral infection are suffering long term damage to their lungs. This damage is often caused by fibrosis, the formation of an abnormal amount of fibrous tissue as a result of persistent inflammation and damage of the tissue. Treatments for fibrosis can mitigate the symptoms and slow down disease progression, but there is no cure. Those suffering these chronic conditions have a very poor quality of life. Covid-19 is likely to increase the number of these patients, adding to the long-term cost of healthcare which society needs to bear. Mesenchymal Stroma Cells (MSC) sourced form adult bone marrow and fat tissue have been used in cell therapies and shown to be safe and have some capacity to reduce fibrosis. In part this is a "paracrine" effect, where the MSC secrete bioactive factors which give rise to the therapeutic benefit either in cells adjacent to the MSC or elsewhere in the patient's body. But MSC sourced from adult donors have only a limited capacity to replicate. This means that the use of adult MSC requires repeated procurement of starting tissue which is expensive and leads to batch-to-batch variation. We have developed a patented technology to produce MSC-like cells from pluripotent stem cells (PSC). As PSC can be expanded almost indefinitely, we are able to produce almost unlimited quantities of clinically identical MSC using our process. In this project, we will investigate the capacity of our MSC to tackle fibrosis and the possibility that this can be achieved by the bioactive factors secreted by the cells. Our ambition is to develop a therapy which does not require MSC to be transplanted into a patient, but only the bioactive factors these cells produce. During the project we will be advised by clinicians as to how the healthcare burden of post-Covid therapy is developing and will refine our therapy development strategy as this need becomes more clear. By starting this research now, we aim to have a scalable therapy available as the need arises.