The Role of Surface in the Pathogenesis and Treatment of COVID-19
Round 1
Reviewer 1 Report
This hypothesis paper contributes to the discussion of the the COVID-19 patho-mechanism. The potentially essential role of Surfactant Protein-D in the host immune defense to respiratory inflammation and infections has been researched and discussed in the past two decades. The SARS-Cov-2 infection triggered the research of SP-D in that condition too. There is one clinical study with rhSP-D in Covid-19 running right now.
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
Reviewer 2 Report
Dear authors
Please consider the following comments when revising the manuscript.
Lines 28-32. This part should be rewritten in a correct and concise style.
Line 31. "And because SARS-CoV-2 is a virus naïve to 31 man [8], that defense must be innate."
What do you mean by this sentence that should be corrected.
Lines 45-46. "it appears COVID-19 is a disease process limited primarily to the pulmonary epithelial surface."
Although I do not agree totally with the authors, I think this conclusion should be further justified and explained.
Lines 60-61. "Given both the dose dependence and the certain existence of an innate defense, symptomatic SARS-CoV-2 infection must be a consequence of a viral dose that exceeds temporally the capacity of the innate defense."
This should be further developed and justified using references.
Lines 62 -64. "And because available evidence suggests symptomatic COVID-19 involves engagement of TLR4 on pulmonary epithelium, the innate defense operating to prevent engagement likely involves an effector native to the pulmonary epithelial surface."
I did not understand the relationship and how this conclusion was achieved?This should be further clarified.
Lines 76-98. Although I understand that higher serum SP-D level are considered as potential biomarker for the severity of COVID-19, the relationships you gave in this part should be further clarified and the text should be corrected and rewritten in a direct and concise style.
The closing notes should be revised. Please avoid conclusions not discussed or referenced.
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
Round 2
Reviewer 2 Report
Dear authors
Many thanks for the answers