Unraveling the enigma: The emerging significance of pulmonary surfactant proteins in predicting, diagnosing, and managing COVID‐19

Abstract Background Severe cases of COVID‐19 often lead to the development of acute respiratory syndrome, a critical condition believed to be caused by the harmful effects of SARS‐CoV‐2 on type II alveolar cells. These cells play a crucial role in producing pulmonary surfactants, which are essential for proper lung function. Specifically focusing on surfactant proteins, including Surfactant protein A (SP‐A), Surfactant protein B, Surfactant protein C, and Surfactant protein D (SP‐D), changes in the levels of pulmonary surfactants may be a significant factor in the pathological changes seen in COVID‐19 infection. Objective This study aims to gain insights into surfactants, particularly their impacts and changes during COVID‐19 infection, through a comprehensive review of current literature. The study focuses on the function of surfactants as prognostic markers, diagnostic factors, and essential components in the management and treatment of COVID‐19. Finding In general, pulmonary surfactants serve to reduce the surface tension at the gas–liquid interface, thereby significantly contributing to the regulation of respiratory mechanics. Additionally, these surfactants play a crucial role in the innate immune system within the pulmonary microenvironment. Within the spectrum of COVID‐19 infections, a compelling association is observed, characterized by elevated levels of SP‐D and SP‐A across a range of manifestations from mild to severe pneumonia. The sudden decline in respiratory function observed in COVID‐19 patients may be attributed to the decreased synthesis of surfactants by type II alveolar cells. Conclusion Collectin proteins such as SP‐A and SP‐D show promise as biomarkers, offering potential avenues for predicting and monitoring pulmonary alveolar injury in the context of COVID‐19. This clarification enhances our understanding of the molecular complexities contributing to respiratory complications in severe COVID‐19 cases, providing a foundation for targeted therapeutic approaches using surfactants and refined clinical management strategies.