{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T08:23:49Z","timestamp":1785572629461,"version":"3.56.0"},"reference-count":111,"publisher":"Portland Press Ltd.","issue":"8","license":[{"start":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T00:00:00Z","timestamp":1690416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"we did not recive funds"}],"content-domain":{"domain":["portlandpress.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Patients with COVID-19 exhibit similar symptoms to neonatal respiratory distress syndrome. SARS-CoV-2 spike protein has been shown to target alveolar type 2 lung cells which synthesize and secrete endogenous surfactants leading to acute respiratory distress syndrome in some patients. This was proven by post-mortem histopathological findings revealing desquamated alveolar type 2 cells. Surfactant use in patients with COVID-19 respiratory distress syndrome results in marked improvement in respiratory parameters but not mortality which needs further clinical trials comparing surfactant formulas and modes of administration to decrease the mortality. In addition, surfactants could be a promising vehicle for specific drug delivery as a liposomal carrier, which requires more and more challenging efforts. In this review, we highlight the current reviews and two clinical trials on exogenous surfactant therapy in COVID-19-associated respiratory distress in adults, and how surfactant could be a promising drug to help fight the COVID-19 infection.<\/jats:p>","DOI":"10.1042\/bsr20230504","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T08:30:36Z","timestamp":1690446636000},"update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Surfactant replacement therapy as promising treatment for COVID-19: an updated narrative review"],"prefix":"10.1042","volume":"43","author":[{"given":"Khaled","family":"Khudadah","sequence":"first","affiliation":[{"name":"1Kuwait Oil Company Ahmadi Hospital, Al Ahmadi, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaa","family":"Ramadan","sequence":"additional","affiliation":[{"name":"2Faculty of Medicine, South Valley University, Qena, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Othman","sequence":"additional","affiliation":[{"name":"1Kuwait Oil Company Ahmadi Hospital, Al Ahmadi, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neveen","family":"Refaey","sequence":"additional","affiliation":[{"name":"3Women\u2019s Health department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr","family":"Elrosasy","sequence":"additional","affiliation":[{"name":"4Faculty of Medicine, Cairo University, Cairo, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayoub","family":"Rezkallah","sequence":"additional","affiliation":[{"name":"5Faculty of Medicine, University of Algeirs, Algeirs, Algeria"},{"name":"6Department of Hematology Laboratory and Blood Transfusion, Hospital Center University Lamine Debaghine, Algeirs, Algeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toka","family":"Heseba","sequence":"additional","affiliation":[{"name":"7Faculty of Medicine, Assuit University, Assuit, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa\u00a0Hossam\u00a0El\u00a0Din","family":"Moawad","sequence":"additional","affiliation":[{"name":"8Faculty of Pharmacy, Clinical Department, Alexandria University, Egypt"},{"name":"9Faculty of Medicine, Suez Canal University, Ismailia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammar","family":"Mektebi","sequence":"additional","affiliation":[{"name":"10Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sewar\u00a0A","family":"Elejla","sequence":"additional","affiliation":[{"name":"11Faculty of Medicine, Alquds University, Jerusalem, Palestine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8917-671X","authenticated-orcid":false,"given":"Mohamed","family":"Abouzid","sequence":"additional","affiliation":[{"name":"12Department of Physical Pharmacy and Pharmacokinetics, Faculty of Pharmacy, Poznan University of Medical Sciences, Rokietnicka 3 St., 60-806 Poznan, Poland"},{"name":"13Doctoral School, Poznan University of Medical Sciences, 60-812 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basel","family":"Abdelazeem","sequence":"additional","affiliation":[{"name":"14McLaren Health Care, Flint, Michigan, U.S.A."},{"name":"15Michigan State University, East Lansing, Michigan, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2023,8,9]]},"reference":[{"key":"2023080905154851900_B1","doi-asserted-by":"publisher","first-page":"A153","DOI":"10.1016\/j.chest.2021.07.173","article-title":"Left atrial thrombus and covid-19-associated coagulopathy","volume":"160","author":"Eva","year":"2021","journal-title":"Chest"},{"key":"2023080905154851900_B2","doi-asserted-by":"publisher","first-page":"2638","DOI":"10.3390\/cells9122638","article-title":"Comprehensive structural and molecular comparison of spike proteins of SARS-CoV-2, SARS-CoV and MERS-CoV, and their interactions with ACE2","volume":"9","author":"Hatmal","year":"2020","journal-title":"Cells"},{"key":"2023080905154851900_B3","doi-asserted-by":"publisher","first-page":"203","DOI":"10.5694\/mja2.51353","article-title":"Care of older people and people requiring palliative care with COVID-19: guidance from the Australian National COVID-19 Clinical Evidence Taskforce","volume":"216","author":"Cheyne","year":"2022","journal-title":"Med. 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