Modeling the effect of COVID-19 disease on the cardiac function: a computational study

Abstract

Background

The effect of COVID-19 on the cardiac function and on the vascular system increases the morbidity and mortality of infected subjects with cardiovascular diseases.

Objectives

To provide preliminary results on cardiac global outcomes (such as cardiac output, ventricular pressures) obtained by means of computational models in plausible scenarios characterized by COVID-19.

Methods

We considered a lumped parameters computational model of the cardiovascular system, which models, from the mechanical point of view, the systemic and pulmonary circulations, the four cardiac valves and the four heart chambers, through mathematical equations of the underlying physical processes. To study the effect of COVID-19, we varied the heart rate, the contractility and the pulmonary resistances in suitable ranges.

Results

Our computations on individuals with both otherwise normal and impaired cardiac functions revealed that COVID-19 worsen cardiac function, as shown by a decrease of some cardiac biomarkers values such as cardiac output and ejection fraction. In the case of existing impaired cardiac function, the presence of COVID-19 lead to values outside the normal ranges.

Conclusions

Computational models revealed to be an effective tool to study the effect of COVID-19 on the cardiovascular system. Such effect could be significant for patients with impaired cardiac function. This is especially useful to perform a sensitivity analysis of the hemodynamics for different conditions.

CONDENSED ABSTRACT

Emerging studies address how COVID-19 infection might impact the cardiovascular system. This relates particularly to the development of myocardial injury, acute coronary syndrome, myocarditis, arrhythmia, and heart failure. Prospective treatment approach is advised for these patients. By the assessment of conventional important biomarkers obtained with new sources as a 0-dimentional computational model, we propose a new study protocol as an effective method to evaluate short-term prognosis. The clinical protocol proposed will help to rapidly identify which patients require intensive monitoring, diagnostic strategy and most adequate therapy.

SciScore for 10.1101/2020.06.23.166421: (What is this?)

Please note, not all rigor criteria are appropriate for all manuscripts.

Table 1: Rigor

NIH rigor criteria are not applicable to paper type.

Table 2: Resources

No key resources detected.

Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:

Study limitations: This study was based on a 0D computational model, which considers compartmental flow rates and pressures. A more detailed study for predicting pointwise quantities of interest in the heart could be carried out by means of a 3D-0D model, where the heart (or a part of it) is simulated by means of a 3D electromechanical model, whose geometry can be personalized starting from clinical images (CT or MRI) acquired from a specific patient. This is currently under study (Regazzoni F, Salvador M, Africa P, Fedele M, Dede’ L, Quarteroni A. Electromechanical modeling of the human heart coupled with a circulation model of the whole cardiovascular system, in preparation). Our computational model neglected the effect of pressure variations due to respiration on the rib cage, hence on the cardiocirculatory system. Albeit we deem this assumption to have a very limited impact on the outcomes of this study, we plan to improve our 0D model for further studies on this topic.

Results from TrialIdentifier: No clinical trial numbers were referenced.

Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

Results from JetFighter: We did not find any issues relating to colormaps.

Results from rtransparent:

Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
No funding statement was detected.
No protocol registration statement was detected.

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