Journal article
COVID-19: Understanding Inter-Individual Variability and Implications for Precision Medicine
Mayo Clinic proceedings, Vol.96(2), pp.446-463
02/01/2021
DOI: 10.1016/j.mayocp.2020.11.024
PMCID: PMC7713605
PMID: 33549263
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 out-patients. 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. (C) 2020 Mayo Foundation for Medical Education and Research
Details
- Title: Subtitle
- COVID-19: Understanding Inter-Individual Variability and Implications for Precision Medicine
- Creators
- Naveen L. Pereira - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MNFerhaan Ahmad - Roy J. and Lucille A. Carver College of MedicineMirnela Byku - University of North Carolina at Chapel HillNathan W. Cummins - Division of Infectious Diseases, Mayo Clinic, Rochester, MNAlanna A. Morris - Emory UniversityAnjali Owens - University of PennsylvaniaSony Tuteja - University of PennsylvaniaSharon Cresci - Washington University in St. Louis
- Resource Type
- Journal article
- Publication Details
- Mayo Clinic proceedings, Vol.96(2), pp.446-463
- DOI
- 10.1016/j.mayocp.2020.11.024
- PMID
- 33549263
- PMCID
- PMC7713605
- NLM abbreviation
- Mayo Clin Proc
- ISSN
- 0025-6196
- eISSN
- 1942-5546
- Publisher
- Elsevier
- Number of pages
- 18
- Language
- English
- Date published
- 02/01/2021
- Academic Unit
- Radiology; Molecular Physiology and Biophysics; Cardiovascular Medicine; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
- Record Identifier
- 9984297508402771
Metrics
21 Record Views