Abstract
As of September 2021, the number of patients diagnosed with COVID-19 worldwide has exceeded 221 million; while the Case Fatality Rate in 215 countries and regions is 2.06%. Acute Respiratory Distress Syndrome (ARDS) is the most common complication of COVID-19 and was reported had a 28-day mortality rate of 74%. Pulmonary injury in ARDS is caused by damage to the alveolar epithelium and pulmonary vascular endothelium caused by both direct virulence of SARS-CoV-2 and an inflammatory reaction that mediates neutrophil activation, leading to diffuse alveolar damage, pulmonary edema and surfactant dysfunction. Under inflammatory conditions, such as ARDS, increased alveolar-capillary permeability may result in alveolar Surfactant Protein-D (SP-D) leakage into the circulation, thus SP-D can be used as a specific biomarker of pulmonary epithelial damage and acute lung injury. SP-D is a specific biomarker of lung epithelial injury and has been shown to correlate with the severity and mortality of ARDS (COVID-19 and non COVID-19). Therefore, the use of SP-D as a prognostic biomarker in COVID-19 cases can be considered.
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