The impact of ventilation–perfusion inequality in COVID-19: a computational model
Mattia Busana, Lorenzo Giosa, Massimo Cressoni, Alessio Gasperetti, Luca Di Girolamo, Alessandra Martinelli, Aurelio Sonzogni, Ferdinando Luca Lorini, Maria Michela Palumbo, Federica Romitti, Simone Gattarello, Irene Steinberg, Peter Herrmann, Konrad Meissner, Michael Quintel, Luciano Gattinoni
Abstract
Hypothesizing that the non-aerated lung fraction as evaluated by the quantitative analysis of the lung computed tomography (CT) equals shunt (V A /Q = 0), we used a computational approach to estimate the magnitude of the ventilation–perfusion mismatch in severe COVID-19. The results show that a severe hyperperfusion of poorly ventilated lung region is likely the cause of the hypoxemia observed. The extensive microthrombosis of the pulmonary circulation may represent the pathophysiological mechanism of such V A /Q distribution.