Journal of Cardiac Arrhythmias (Jun 2020)

The Use of Core Warming as a Treatment for Coronavirus Disease 2019 (COVID-19): an Initial Mathematical Model

  • Marcela Mercado-Montoya,
  • Nathaniel Bonfanti,
  • Emily Gundert,
  • Anne Meredith Drewry,
  • Roger Bedimo,
  • Victor Kostov,
  • Konstantin Kostov,
  • Shailee Shah,
  • Erik Kulstad

DOI
https://doi.org/10.24207/jca.v33i1.3382
Journal volume & issue
Vol. 33, no. 1
pp. 6 – 15

Abstract

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Introduction: Increasing data suggest that elevated body temperature may be helpful in resolving a variety of diseases, including sepsis, acute respiratory distress syndrome (ARDS), and viral illnesses such as SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19). A mechanical provision of elevated temperature focused in a body region of high viral activity in patients undergoing mechanical ventilation may offer a therapeutic option that avoids arrhythmias seen with some pharmaceutical treatments. This study investigated the potential to actively provide core warming to the lungs of patients with a commercially available heat transfer device via mathematical modeling, and examined the influence of blood perfusion on temperature using this approach. Methods: Using the software Comsol Multiphysics, the authors modeled and simulated heat transfer in the body from an intraesophageal warming device, taking into account the airflow from patient ventilation. The simulation was focused on heat transfer and warming of the lungs and performed on a simplified geometry of an adult human body and airway from the pharynx to the lungs. Results: Simulations were run over a range of values for blood perfusion rate, since the heat capacity and density remain relatively constant. The highest temperature in this case is the device warming water temperature, and that heat diffuses by conduction to the nearby tissues, including the air flowing in the airways. At the range of blood perfusion investigated, maximum lung temperature ranged from 37.6 to 38.6°C. Conclusions: The provision of core warming may offer an innovative approach to treating infectious diseases from viral illnesses such as COVID-19, while avoiding the arrhythmogenic complications of currently used pharmaceutical treatments.

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