Pulmonary surfactant potential treatment for COVID-19-induced respiratory failure

Researchers at Lawson Health Research Institute (Lawson) have launched a new study to investigate the use of bovine lipid extract surfactant suspension (BLES^®) for treating severe cases of COVID-19. They hope to improve COVID-19 outcomes, and reduce the time needed on mechanical ventilation for severe cases.

Surfactant is made of lipids and proteins. Its primary function is to reduce surface tension in the alveoli in the lungs, helping us to exchange gases and breathe more efficiently. Alveoli can be described as tiny, balloon-like air sacs that exchange oxygen and carbon dioxide to and from the blood stream. When there is less surfactant being produced, or the surfactant is dysfunctional, alveolar walls can stick together, making it difficult to breathe.

Lung analyses from patients with severe COVID-19-induced respiratory failure indicate there is a change in their alveolar type-II cells; the cells which secrete surfactant. This suggests a change to the surfactant being produced, and a decrease in its functional efficacy.

Dr. Jim Lewis, Lawson Scientist and Respirologist at St. Joseph’s Health Care London, and his colleague, Lawson Scientist Dr. Ruud Veldhuizen, are studying whether the use of BLES^®, an exogenous surfactant, given at the time of intubation, will help improve outcomes such as gas exchange, need for mechanical ventilation, systemic inflammatory response, and length of ICU and hospital stay in patients with severe COVID-19.

BLES® is a pulmonary surfactant, manufactured in London, Ontario. It is currently used worldwide to help improve lung function in premature babies. Researchers are confident that it can help adults who develop lung disease and acute respiratory distress syndrome (ARDS).

Dr. Jim Lewis explains, “BLES® has been studied in pediatric and adult populations with ARDS, and we have found that it improves outcomes in patients with direct lung injury when compared to patients receiving standard treatment. We have proven this treatment effective in the past, and COVID-19 seems to be another prototypic case that we think will respond well.”

“Mechanical ventilation, while sometimes necessary, can cause damage to the lungs,” says Dr. Veldhuizen. “In previous studies, we’ve been able to show that if you give the surfactant early, prior to ventilation, you can prevent some of this damage from occurring.”

“The world is focused on finding good treatments for COVID-19. This kind of research is only possible through strong partnerships, and we are thankful for the collaboration that is possible here in London. Many different experts are involved in this study, including scientists and research staff, physicians, nurses, respiratory therapists, pharmacists, and staff at BLES® Biochemicals,” adds Dr. Veldhuizen.

Researchers hope to recruit ten patients to receive the exogenous surfactant, with another ten serving as the control group.