SARS-CoV2 can lead to a severe form of pneumonia, which under certain circumstances can trigger acute lung failure (ARDS, „Acute Respiratory Distress Syndrome“). This is an „excessive“ inflammatory response: inflammatory cells and fluid build up in the lungs. This hinders breathing mechanically on the one hand, and on the other hand destroys the anti-inflammatory fluid, the body's own protective film („surfactant“) in the alveoli, which can no longer absorb oxygen as a result. SARS-CoV-2 induces the destruction of Type II alveolar cells in COVID-19-associated pneumonia. Type II alveolar cells produce lung surfactant. Surfactant is required for the maintenance of respiratory mechanics by reducing surface tension and thus preventing lung collapse. Furthermore, the massive release of cytokines from lymphocytopenia is another factor that leads to lung failure and death in severe COVID-19 patients.
In the literature, there is currently intensive discussion about whether surfactant could be of great benefit in the treatment of adult respiratory distress syndrome.
Some authors speculate that early administration of a natural pulmonary surfactant could improve lung function to restore lung barrier function in patients with COVID-19 pneumonia, thereby shortening the duration of ventilation therapy and aiding patient recovery. Indeed, this could be easily achieved by placing the reconstituted lyophilisate powder into the tracheal tube of the ventilated COVID-19 patient. Another hypothesis suggests that surfactant could be effective not only for the treatment but also for the prophylactic protection of SARS-CoV-2. Each theory argues that pulmonary surfactant is not only beneficial for reducing surface tension or increasing lung compliance, but is also a powerful protection against the virus itself. However, none of the theories are actually supported with real experimental evidence. Numerous clinical trials are currently underway to determine whether treatment with surfactant can be considered beneficial in COVID-19 induced respiratory failure.
It has always been our clear and unwavering focus to follow the science to achieve the best possible benefit for our patients. Against this background, we hope to be able to make our contribution to the fight against COVID-19 as a surfactant manufacturer.
Dr Dr Romina Weinhold
Head of Medical Affairs
Lyomark Pharma GmbH