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COVID-19: Understanding Inter-Individual Variability and Implications for Precision Medicine.
Pereira, Naveen L; Ahmad, Ferhaan; Byku, Mirnela; Cummins, Nathan W; Morris, Alanna A; Owens, Anjali; Tuteja, Sony; Cresci, Sharon.
  • Pereira NL; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN. Electronic address: pereira.naveen@mayo.edu.
  • Ahmad F; Department of Internal Medicine, Division of Cardiovascular Medicine, University of Iowa Carver College of Medicine Iowa City, IA.
  • Byku M; Department of Medicine, Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
  • Cummins NW; Division of Infectious Diseases, Mayo Clinic, Rochester, MN.
  • Morris AA; Division of Cardiology, Emory University, Atlanta, GA.
  • Owens A; Department of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Tuteja S; Division of Translational Medicine and Human Genetics, Department of Medicine, University of Pennsylvania, Philadelphia, PA.
  • Cresci S; Department of Medicine and Genetics, Washington University, St Louis, MO.
Mayo Clin Proc ; 96(2): 446-463, 2021 02.
Article in English | MEDLINE | ID: covidwho-1065451
ABSTRACT
Coronavirus disease 2019 (COVID-19) is characterized by heterogeneity in susceptibility to the disease and severity of illness. Understanding inter-individual variation has important implications for not only allocation of resources but also targeting patients for escalation of care, inclusion in clinical trials, and individualized medical therapy including vaccination. In addition to geographic location and social vulnerability, there are clear biological differences such as age, sex, race, presence of comorbidities, underlying genetic variation, and differential immune response that contribute to variability in disease manifestation. These differences may have implications for precision medicine. Specific examples include the observation that androgens regulate the expression of the enzyme transmembrane protease, serine 2 which facilitates severe acute respiratory syndrome coronavirus 2 viral entry into the cell; therefore, androgen deprivation therapy is being explored as a treatment option in males infected with COVID-19. An immunophenotyping study of COVID-19 patients has shown that a subset develop T cytopenia which has prompted a clinical trial that is testing the efficacy of interleukin-7 in these patients. Predicting which COVID-19 patients will develop progressive disease that will require hospitalization has important implications for clinical trials that target outpatients. Enrollment of patients at low risk for progression of disease and hospitalization would likely not result in such therapy demonstrating efficacy. There are efforts to use artificial intelligence to integrate digital data from smartwatch applications or digital monitoring systems and biological data to enable identification of the high risk COVID-19 patient. The ultimate goal of precision medicine using such modern technology is to recognize individual differences to improve health for all.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Precision Medicine / Biological Variation, Population / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Humans Language: English Journal: Mayo Clin Proc Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Precision Medicine / Biological Variation, Population / COVID-19 Type of study: Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Vaccines Limits: Humans Language: English Journal: Mayo Clin Proc Year: 2021 Document Type: Article