Abstract
To provide novel data on surfactant levels in adult COVID-19 patients, we collected bronchoalveolar lavage fluid less than 72 h after intubation and used Fourier Transform Infrared Spectroscopy to measure levels of dipalmitoylphosphatidylcholine (DPPC). A total of eleven COVID-19 patients with moderate-to-severe ARDS (CARDS) and 15 healthy controls were included. CARDS patients had lower DPPC levels than healthy controls. Moreover, a principal component analysis was able to separate patient groups into distinguishable subgroups. Our findings indicate markedly impaired pulmonary surfactant levels in COVID-19 patients, justifying further studies and clinical trials of exogenous surfactant.
Highlights
To provide novel data on surfactant levels in adult COVID-19 patients, we collected bronchoalveolar lavage fluid less than 72 h after intubation and used Fourier Transform Infrared Spectroscopy to measure levels of dipalmitoylphosphatidylcholine (DPPC)
DPPC values were different across the three groups (Fig. 1, P < 0.0001) with approximately 60% lower levels in COVID-19 patients with moderate-to-severe ARDS (CARDS) than in HCs
It has been speculated that increased alveolar surface tension due to loss of surfactant may predispose to pulmonary barotrauma, and our findings provide a potential mechanism of the higher incidence of subcutaneous emphysema, pneumothorax, and pneumomediastinum in mechanically ventilated CARDS patients (~ 17%) compared to non-COVID ARDS (~ 5–11%)[11]
Summary
To provide novel data on surfactant levels in adult COVID-19 patients, we collected bronchoalveolar lavage fluid less than 72 h after intubation and used Fourier Transform Infrared Spectroscopy to measure levels of dipalmitoylphosphatidylcholine (DPPC). A total of eleven COVID-19 patients with moderate-to-severe ARDS (CARDS) and 15 healthy controls were included. Our findings indicate markedly impaired pulmonary surfactant levels in COVID-19 patients, justifying further studies and clinical trials of exogenous surfactant. Virus-induced lysis or apoptosis of ATII cells and loss of surfactant in coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome (CARDS) may lead to diffuse alveolar damage, protein leak, and hyaline membrane formation[2,3]. Exogenous surfactant therapy is effective for premature new-borns with respiratory distress syndrome (RDS), it has failed to improve mortality in non-COVID-19 A RDS5. For the first time, show reduced DPPC levels in COVID-19 patients with moderate-to-severe ARDS assessed in bronchoalveolar lavage fluid (BALF) assessed by a recently developed fast POC method
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
