Lia Kubelka, PhD
In December 2019, the world began to face a new reality. A new virus appears, and with it a new pandemic that is unprecedented for humanity. The global spread of COVID-19 can be described as the worst pandemic in humanity in the last century.
The first moment was of worry and reflection: what would be the next steps? What are the possible forms of combat? What is the behavior of the virus? How is the pathophysiology of the disease? There were months of intense study. Several research centers have come together brilliantly to produce results. Never in the history of science have results been generated and published so quickly. So, science has advanced a lot in just six months.
The great lesson I see from these months of the pandemic is that undoubtedly, it is time for individualized medicine.
The virus behaves completely differently in each individual. For the majority, it goes completely unnoticed, in others it causes a brief and inconvenient discomfort and for a significant but smaller percentage of individuals it is overwhelming and lethal. So, the “one fits all” approach, is no longer the best in this pandemic.
Obesity is one of the most important conditions that increases exponentially the mortality risk of SARS-CoV-2 patients. And this is the second epidemic we face in the world today. Besides obesity, diabetes, hypertension, heart conditions and another chronic disease increase the complications of the disease. Literature data demonstrate that there is a direct metabolic link between the state of inflammation and the “cytokine storm” contributing to the respiratory decline of COVID-19.
In the context of individualized medicine, the analysis of genetic polymorphisms can be an important tool to the prevention and possible aggravation of the disease. The analysis of genetic risk for obesity, diabetes, hypertension and nutritional deficiencies, can help patients and health professionals in making decisions regarding the health protocols to be taken.
Hypothesis-driven approaches to assess variants of specific, metabolically relevant genes in subjects enrolled in nutritional interventions can improve health and prevent complications.
In this scenario, where science has progressed more and more and with an emphasis on genomics and telemedicine, we have the ideal moment for the implementation of individualized medicine. The patient increasingly wants to take control and responsibility for his own health and the knowledge of his own DNA creates empowerment when health has never been so important.
About the author: Lia Kubelka Fernandes de Carlos Back has a degree in Pharmacy, a Master’s in Biotechnology applied to health with an area of concentration in Human Molecular Genetics, a PhD from the Postgraduate Program in Cellular and Developmental Biology, where she studied immunogenetic markers for the development of Breast Cancer. She is Scientific Director and founder of Biogenetika – Center for Individualized Medicine.
References:
[1] Vabret, N., Britton, G. J., Gruber, C., Hegde, S., Kim, J., Kuksin, M., … Samstein, R. M. (2020). Immunology of COVID-19: current state of the science. Immunity. https://doi.org/10.1016/j.immuni.2020.05.002.
[2] Kalligeros, M., Shehadeh, F., Mylona, E. K., Benitez, G., Beckwith, C. G., Chan, P. A., & Mylonakis, E. (2020). Association of Obesity with Disease Severity among Patients with COVID-19. Obesity (Silver Spring, Md.), 0–2. https://doi.org/10.1002/oby.22859.
[3] Wu, Z., & McGoogan, J. M. (2020). Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA – Journal of the American Medical Association, 2019. https://doi.org/10.1001/jama.2020.2648.
[4] Zhou, F., Yu, T., Du, R., Fan, G., Liu, Y., Liu, Z., … Cao, B. (2020). Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet, 395(10229), 1054–1062. https://doi.org/10.1016/S0140-6736(20)30566-3.
[5] Qi, Q., Kilpeläinen, T. O., Downer, M. K., Tanaka, T., Smith, C. E., Sluijs, I., … Qi, L. (2014). FTO genetic variants, dietary intake, and body mass index: insights from 177,330 individuals. Human Molecular Genetics, 23(25), 1–12. https://doi.org/10.1093/hmg/ddu411.