- patients will be excluded from the study if one of the following applies: - history of hypersensitivity to any drugs of similar classes to exosomes - suspected active uncontrolled bacterial, fungal, or viral (besides sars-cov-2) infection - currently receiving ecmo, nitric oxide therapy, or high-frequency oscillatory ventilation - in the option of the investigator, the patient is unlikely to survive for more than 24 hours post-enrollment - patients who are on long-term use of select oral or injectable anti-rejection or immunomodulatory drugs - pregnant or nursing (lacking) women

- patients will be excluded from the study if one of the following applies: - history of hypersensitivity to any drugs of similar classes to exosomes - suspected active uncontrolled bacterial, fungal, or viral (besides sars-cov-2) infection - currently receiving ecmo, nitric oxide therapy, or high-frequency oscillatory ventilation - in the option of the investigator, the patient is unlikely to survive for more than 24 hours post-enrollment - patients who are on long-term use of select oral or injectable anti-rejection or immunomodulatory drugs - pregnant or nursing (lacking) women