The Computational Patient has Diabetes and a COVID

Barbiero, P.; Lio, P.

Medicine is moving from reacting to a disease to prepare personalised and precision paths to well being. The complex and multi level pathophysiological patterns of most diseases require a systemic medicine approach and are challenging current medical therapies. Computational medicine is a vibrant interdisciplinary field that could help moving from an organ-centered to a process-oriented or systemic medicine data analysis. The resulting Computational patient may require an international interdisciplinary effort, probably of larger scientific and technological interdisciplinarity than the human genome sequencing. When deployed, it will have a profound impact on how healthcare is delivered to patients. Here we present a Computational patient model that integrates, refine and extend recent specific mechanistic or phenomenological models of cardiovascular, RAS and diabetic processes. Our aim is twofold: analyse the modularity and composability of the models-building blocks of the Computational patient and to study the dynamical properties of well-being and disease states in a broader functional context. We present results from a number of experiments among which we characterise the dynamical impact of covid-19 and T2D diabetes on cardiovascular and inflammation conditions. We tested these experiments under exercise and meals and drug regimen. We report results showing the striking importance of transient dynamical responses to acute state conditions and we provide guidelines for system design principle of the inter-relationship between modules and components for systemic medicine. Finally this initial Computational Patient can be used as a toolbox for further modifications and extensions.