COVID-19 and Tissue Engineering: What Have We Accomplished in the Past 5 Years?

The Coronavirus Disease of 2019 (COVID-19) pandemic caused by SARS-CoV-2 resulted in widespread mortality, economic strain, and healthcare system disruption, highlighting the need for effective strategies to address viral threats. Tissue engineering and biomaterials can contribute significantly in advancing our understanding and treatment of respiratory viral infections by developing physiologically relevant in vitro models, controlled and targeted drug delivery systems, and effective next-generation vaccine platforms. Over the last 5 years, tissue-engineered cell-based models, including organ-on-a-chip systems, have improved our understanding of viral entry, immune response, and therapeutic efficacy in pulmonary, cardiac, neurological, and vascular tissue. Biomaterial-based delivery systems have enhanced the targeting, bioavailability, and sustained delivery of therapeutics such as antivirals, monoclonal antibodies, nucleic-acid-based vaccines, and anti-inflammatory drugs, while also reducing or eliminating system toxicity and our reliance on intravenous administration. Advancements in vaccine platforms using lipid nanoparticles, protein scaffolds, and vesicular or cell-based platforms are in different phases of development to stimulate more robust responses against emerging SARS-CoV-2 variants. Collectively, these advancements highlight the influence of tissue engineering and biomaterials in SARS-CoV-2 research and treatment. This review provides an overview of recent developments in in vitro modeling, drug delivery systems, and vaccine platforms, highlighting their future role in improving clinical outcomes, managing variants, and preparing for potential future pandemics, including addressing challenges in infrastructure such as limited access to high-containment biosafety facilities used to study emerging infectious pathogens.Impact StatementDuring the COVID-19 pandemic, we introduced basic tenets of virology to a tissue engineering audience and proposed different areas in which the field could contribute to developing diagnostics and therapeutics for respiratory viral infections. In this 5-year update, we highlight how tissue engineers and biomaterial scientists contributed tools to dissect virus pathophysiology and deliver therapies such as mRNA vaccines to prevent mortality during the pandemic. With the emergence of new variants and the threat of new respiratory viral pandemics, tissue engineers can continue to play important roles in virology.