COVID-19: Understanding Inter-Individual Variability and Implications for Precision Medicine

    February 2021 in “ Mayo Clinic Proceedings
    Naveen L. Pereira, Ferhaan Ahmad, Mirnela Byku, Nathan W. Cummins, Alanna A. Morris, Anjali Tiku Owens, Sony Tuteja, Sharon Cresci
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    TLDR The conclusion is that individual differences in COVID-19 severity are influenced by factors like age, sex, race, and genetics, which are important for personalized medicine.
    The document from February 1, 2021, examines the factors contributing to the variability in COVID-19 susceptibility and severity among individuals, which is significant for precision medicine. It identifies age, sex, race, comorbidities, genetic variation, and immune response as key contributors to disease manifestation, with males and certain racial and ethnic groups at higher risk. Androgen deprivation therapy is being considered due to its potential impact on viral entry into cells. Immunophenotyping studies have led to clinical trials for interleukin-7 in patients with T cytopenia. Artificial intelligence is being used to identify high-risk patients by integrating digital and biological data. Genetic factors such as variations in ACE, ACE2, TMPRSS2, ABO blood group, and HLA genes are discussed, with certain populations having higher susceptibility based on allele frequencies. The document also explores the role of genetic variations in immune response genes and a Neanderthal-derived haplotype in COVID-19 severity. It reviews the mixed results of pharmacological therapies and the importance of biomarkers in prognosis. The variability in vaccine response is highlighted, with the first phase 1 trial showing significant differences among participants. The document underscores the need for large-scale genetic studies and the use of technology to manage disease progression and improve targeted therapy and vaccine distribution through precision medicine.
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