Thierry Alain R
Research Institute of Cancerology of Montpellier, INSERM U1194, IRCM, ICM, Montpellier University, Montpellier F-34298, France.
Precis Clin Med. 2020 Jul 21;3(3):228-234. doi: 10.1093/pcmedi/pbaa026. eCollection 2020 Sep.
If the current rate of infection are to be better managed, and future waves of infection kept at bay, it is absolutely necessary that the conditions and mechanisms of exposure to Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) be better understood, as well as the downstream severe or lethal clinical complications. While the identification of notable comorbidities has now helped to define broad risk groups, the idiosyncratic responses of individual patients can generate unexpected clinical deterioration that is difficult to predict from initial clinical features. Thus, physicians caring for patients with COVID-19 face clinical dilemmas on a daily basis. The ability to decipher individual predispositions to SARS-CoV-2 infection or severe illness, in light of variations in host immunological and inflammatory responses, in particular as a result of genetic variations, would be of great benefit in infection management. To this end, this work associates the description of COVID-19 clinical complications, comorbidities, sequelae, and environmental and genetic factors. We also give examples of underlying genomic susceptibility to COVID-19, especially with regard to the newly reported link between the disease and the unbalanced formation of neutrophil extracellular traps. As a consequence, we propose that the host/genetic factors associated with COVID-19 call for precision medicine in its treatment. This is to our knowledge the first article describing elements towards precision medicine for patients with COVID-19.
如果要更好地控制当前的感染率，并防止未来的感染浪潮，那么绝对有必要更好地了解感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的条件和机制，以及下游的严重或致命临床并发症。虽然已确定的显著合并症有助于界定广泛的风险群体，但个体患者的特殊反应可能导致意想不到的临床恶化，而这很难根据初始临床特征进行预测。因此，照顾新冠肺炎患者的医生每天都面临临床困境。鉴于宿主免疫和炎症反应的变化，特别是由于基因变异导致的变化，解读个体对SARS-CoV-2感染或严重疾病的易感性的能力，将对感染管理大有裨益。为此，本研究结合了对新冠肺炎临床并发症、合并症、后遗症以及环境和遗传因素的描述。我们还列举了新冠肺炎潜在的基因组易感性实例，特别是关于该疾病与中性粒细胞胞外陷阱不平衡形成之间新报道的联系。因此，我们认为与新冠肺炎相关的宿主/遗传因素要求在其治疗中采用精准医学。据我们所知，这是第一篇描述针对新冠肺炎患者精准医学要素的文章。
