In premature neonates with a primary surfactant deficiency , there is ARDS and surfactants is the main line of therapy. Now it is well known that the virus is attached to and is replicated within type 11 pneumocytes, the main function of these cells is production of surfactants which decrease surface tension and keep the alveoli patent without collapse. In this condition there is a secondary surfactant deficiency which may play a role in pathogenesis and deterioration of patient clinical condition.
So, I suggest that treatment by surfactant therapy either derived from endogenous or exogenous source in severe cases can improve clinical condition, delay or avoid patient ventilation by refilling debilitated surfactants and lavage of bronchial tree, this directly decrease mortality rate.

In premature neonates with a primary surfactant deficiency , there is ARDS and surfactants is the main line of therapy. Now it is well known that the virus is attached to and is replicated within type 11 pneumocytes, the main function of these cells is production of surfactants which decrease surface tension and keep the alveoli patent without collapse. In this condition there is a secondary surfactant deficiency which may play a role in pathogenesis and deterioration of patient clinical condition