Physics-based in silico modelling of microvascular pulmonary perfusion in COVID-19

Proc Inst Mech Eng H. 2024 May;238(5):562-574. doi: 10.1177/09544119241241550. Epub 2024 Apr 2.

Abstract

Due to its ability to induce heterogenous, patient-specific damage in pulmonary alveoli and capillaries, COVID-19 poses challenges in defining a uniform profile to elucidate infection across all patients. Computational models that integrate changes in ventilation and perfusion with heterogeneous damage profiles offer valuable insights into the impact of COVID-19 on pulmonary health. This study aims to develop an in silico hypothesis-testing platform specifically focused on studying microvascular pulmonary perfusion in COVID-19-infected lungs. Through this platform, we explore the effects of various acinar-level pulmonary perfusion abnormalities on global lung function. Our modelling approach simulates changes in pulmonary perfusion and the resulting mismatch of ventilation and perfusion in COVID-19-afflicted lungs. Using this coupled modelling platform, we conducted multiple simulations to assess different scenarios of perfusion abnormalities in COVID-19-infected lungs. The simulation results showed an overall decrease in ventilation-perfusion (V/Q) ratio with inclusion of various types of perfusion abnormalities such as hypoperfusion with and without microangiopathy. This model serves as a foundation for comprehending and comparing the spectrum of findings associated with COVID-19 in the lung, paving the way for patient-specific modelling of microscale lung damage in emerging pulmonary pathologies like COVID-19.

Keywords: COVID-19; Lung mechanics; computational modelling; lung perfusion; pulmonary circulation; ventilation-perfusion ratio.

MeSH terms

  • COVID-19* / physiopathology
  • Computer Simulation*
  • Humans
  • Lung* / blood supply
  • Lung* / physiopathology
  • Microvessels / physiopathology
  • Models, Biological
  • Pulmonary Circulation