Abstract
Introduction: Today, SARS-COV-2 infection represents a global threat. Dealing with this viral infection necessitates a comprehensive understanding of pathophysiology of the disease to reach to the suitable treatment. Treatment of this disease should not be restricted to the usual antiviral treatments, which suffered from several limitations including low effectiveness, development of virus-resistant mutations and the unwanted side effects.Knowing that SARS-CoV-2 attack the machinery unit of production of surfactant in the lung, the alveolar type II cells, manifested the importance of this review article on the role of pulmonary surfactant in this disease and the possible role of pulmonary surfactant that can play in treating of COVID-19 patients.Objective: This work tried to clarify the important role of pulmonary surfactant in lung physiology and possible immune-modulatory effect. In addition, the constituents of pulmonary surfactant and their roles against COVID-19 complications is highlighted. This article suggested that surfactant therapy may have a role in COVID-19 therapy and this can be in a form of exogenous (synthetic) surfactant administrated through endotracheal tube or through aerosolization. The pros and cons of these methods of administration have been discussed. Moreover, a possible way of stimulation of endogenous surfactant by administrating a drug that stimulates the synthesis of surfactant has been suggested.