MOX, Dipartimento di Matematica, Politecnico di Milano, Milan, Italy.
LABS, Dipartimento di Chimica, Materiali e Ingegneria Chimica, Politecnico di Milano, Milan, Italy.
Sci Rep. 2024 Apr 9;14(1):8304. doi: 10.1038/s41598-024-58849-3.
Impaired cardiac function has been described as a frequent complication of COVID-19-related pneumonia. To investigate possible underlying mechanisms, we represented the cardiovascular system by means of a lumped-parameter 0D mathematical model. The model was calibrated using clinical data, recorded in 58 patients hospitalized for COVID-19-related pneumonia, to make it patient-specific and to compute model outputs of clinical interest related to the cardiocirculatory system. We assessed, for each patient with a successful calibration, the statistical reliability of model outputs estimating the uncertainty intervals. Then, we performed a statistical analysis to compare healthy ranges and mean values (over patients) of reliable model outputs to determine which were significantly altered in COVID-19-related pneumonia. Our results showed significant increases in right ventricular systolic pressure, diastolic and mean pulmonary arterial pressure, and capillary wedge pressure. Instead, physical quantities related to the systemic circulation were not significantly altered. Remarkably, statistical analyses made on raw clinical data, without the support of a mathematical model, were unable to detect the effects of COVID-19-related pneumonia in pulmonary circulation, thus suggesting that the use of a calibrated 0D mathematical model to describe the cardiocirculatory system is an effective tool to investigate the impairments of the cardiocirculatory system associated with COVID-19.
心功能障碍已被描述为 COVID-19 相关肺炎的常见并发症。为了探究潜在的机制,我们使用集总参数 0D 数学模型来表示心血管系统。该模型使用记录在 58 例因 COVID-19 相关肺炎住院的患者的临床数据进行了校准,使其具有个体患者的特征,并计算了与心脏循环系统相关的临床感兴趣的模型输出。我们评估了每个校准成功的患者,评估了模型输出估计不确定区间的统计可靠性。然后,我们进行了一项统计分析,比较了健康范围和可靠模型输出的平均值(超过患者),以确定 COVID-19 相关肺炎中哪些发生了显著改变。我们的结果表明,右心室收缩压、舒张压和肺动脉平均压以及毛细血管楔压显著增加。相反,与全身循环有关的物理量没有明显改变。值得注意的是,没有数学模型支持的原始临床数据的统计分析无法检测到 COVID-19 相关肺炎对肺循环的影响,这表明使用校准的 0D 数学模型来描述心脏循环系统是一种有效的工具,可以研究与 COVID-19 相关的心脏循环系统损伤。