Disease Modeling of COVID-19 by a Lung-on-a-Chip Simulation Model for Oxygen Management Purposes

COVID-19 significantly impacts the lung’s gas exchange units by thickening the gas-blood barrier. This study conducted finite element simulations on a COVID-19 lung-on-a-chip model to assess the impact of alveolar barrier tissue remodeling on blood oxygenation during COVID-19. The results can be used to ensure optimal oxygen treatment and mitigate potential side effects of excessive supplementation. First, the formation of a mucus layer with varying thicknesses was simulated. Interestingly, patients experiencing mucus-induced silent hypoxia did not require oxygen treatment, as their oxygen saturation levels consistently exceeded 90% across all mucus thicknesses. Next, the severe exudative and fibrotic phases of COVID-19, characterized by hyaline membrane and fibrotic tissue, were modeled. Oxygen exchange during these phases sharply declined compared to mucus-induced hypoxia, resulting in blood oxygen levels of 1.2 mol/m3 and 0.96 mol/m3 for 1µm thickness of the hyaline membrane and fibrotic tissue. Furthermore, a five-fold increase in the thickness of the hyaline membrane and fibrotic tissue considerably limited oxygen transfer to about 0.29 mol/m3 and 0.2 mol/m3, respectively. The study also suggested the required alveolar oxygen content for 90% blood saturation in different thicknesses of hyaline membrane and fibrotic tissue. For 1µm thickness of the hyaline membrane and fibrotic tissue, the alveolar oxygen content needed to be 16.45% and 20.39%, respectively. The required oxygen increased to 68.42% and 98.68% for 5µm thickness of the hyaline membrane and fibrotic tissue, respectively. Moreover, the investigation showed that changes in blood viscosity, flow rate, and hemoglobin concentration had minimal impact on blood oxygenation during COVID-19 disease. In conclusion, this study provides valuable insights into how alterations in the air-blood barrier and blood disorders in COVID-19 disease affect gas exchange dynamics. It also suggests oxygen treatment requirements for each phase of COVID-19 disease, which can optimize oxygen therapy and improve patient care.