Acute respiratory distress syndrome (ARDS) related to SARS-CoV-2 infection has some unusual characteristics that differentiate it from the pathophysiology described in the more ‘typical’ ARDS. Among multiple hypotheses, a close similarity has been suggested between COVID-19 ARDS and neonatal respiratory distress syndrome (RDS). With this opinion paper, we investigated the pathophysiological similarities between infant respiratory diseases (RDS and direct neonatal ARDS (NARDS)) and COVID-19 in adults. We also analysed, for the first time, similarities in the response to exogenous surfactant administration in terms of improved static compliance in RDS and direct NARDS, and adult COVID-19 ARDS. In conclusion, we believe that if the pathological processes are similar both from the pathophysiological point of view and from the response in respiratory mechanics to a recruitment treatment such as surfactant, perhaps the latter could be considered a plausible option and lead to recruitment in clinical trials currently ongoing on patients with COVID-19. Data are available on reasonable request.

中文翻译：

---

COVID-19 ARDS 中的外源性肺表面活性剂。与新生儿 RDS 的相似之处为“旧”策略提供了新场景

与 SARS-CoV-2 感染相关的急性呼吸窘迫综合征 (ARDS) 具有一些不寻常的特征，使其与更“典型”的 ARDS 中描述的病理生理学不同。在多种假设中，COVID-19 ARDS 与新生儿呼吸窘迫综合征 (RDS) 之间存在密切相似性。通过这篇意见书，我们调查了成人婴儿呼吸道疾病（RDS 和直接新生儿 ARDS (NARDS)）与 COVID-19 之间的病理生理学相似性。我们还首次分析了在改善 RDS 和直接 NARDS 以及成人 COVID-19 ARDS 的静态顺应性方面对外源性表面活性剂给药的反应的相似性。综上所述，我们认为，如果病理过程从病理生理学角度和呼吸力学对表面活性剂等募集治疗的反应相似，也许后者可能被认为是一种合理的选择，并导致目前正在进行的临床试验中的募集COVID-19 患者。可根据合理要求提供数据。