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A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Epidemiology".

Deadline for manuscript submissions: closed (30 January 2022) | Viewed by 37704

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Dr. Rutger A. Middelburg

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Department of Public Health and Primary Care at the Leiden University Medical Center, Leiden, The Netherlands
Interests: epidemiology; research methodology and ethics; personalized medicine; epidemics; and under-researched groups; in particular the elderly

Special Issue Information

Dear colleagues,

Practicing personalized medicine means practicing medicine in such a way that the right patient gets the right treatment at the right time. It thereby reduces both over-treatment and under-treatment. Usually, over-treatment prevails, but during the SARS-CoV-2 epidemic, widespread under-treatment became a serious concern as well.

All epidemics, whether big, like SARS-CoV-2, or relatively small, like the seasonal flu, impact on our ability to practice personalized medicine. This Special Issue focusses on the impact of epidemics on the personalization of medicine, with a special emphasis on under-researched groups such as the (frail) elderly and children.

Personalization of medicine has been advocated and researched for decades. Still, commonly used treatments are effective in only one out of every 16 patients treated. A single epidemic has forced us to be more selective in our treatments than we have been for all these decades. The impact of other epidemics might be smaller but is still likely to be significant.

Currently, we are seeing increasing numbers of publications estimating the numbers of missed diagnoses and delayed treatments, as a result of the SARS-CoV-2 epidemic. However, the potential effects of this under-treatment, on relevant health outcomes, remain largely speculative. Further, triaging potential COVID-19 patients is becoming more and more sophisticated, which is also a form of personalized medicine. In conclusion, epidemics, any epidemic, forces a reconsideration of the allocation of health care resources and, thus, an adaptation of our efforts toward the personalization of medicine.

We are looking for papers which make a novel contribution toward optimizing the personalization of medicine during epidemics. This encompasses both the personalization of diagnoses and treatment of the epidemic disease itself, and adaptations in the personalization of diagnoses and treatment of other diseases, as necessitated by the epidemic. We also welcome “lessons learned” with a translation to other epidemics, both infectious and non-infectious, like obesity and diabetes.

Dr. Rutger A. Middelburg
Guest Editor

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Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

personalized medicine
epidemics
elderly
children
under-treatment
over-treatment
under-diagnoses
over-diagnoses
health care resources

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Published Papers (12 papers)

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Editorial

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2 pages, 176 KiB

Open AccessEditorial

Personalized Medicine in Epidemics

by Rutger A. Middelburg

J. Pers. Med. 2022, 12(4), 583; https://doi.org/10.3390/jpm12040583 - 5 Apr 2022

Viewed by 1428

Abstract

Before you lies the Special Issue “Personalized Medicine in Epidemics” [...] Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

Research

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10 pages, 891 KiB

Open AccessArticle

Impact of Smoking Status on Lung Cancer Characteristics and Mortality Rates between Screened and Non-Screened Lung Cancer Cohorts: Real-World Knowledge Translation and Education

by Fu-Zong Wu, Yun-Ju Wu, Chi-Shen Chen and Shu-Ching Yang

J. Pers. Med. 2022, 12(1), 26; https://doi.org/10.3390/jpm12010026 - 2 Jan 2022

Cited by 9 | Viewed by 2886

Abstract

This was a retrospective hospital-based cohort study of participants diagnosed with lung cancer in the lung cancer register database, and our goal was to evaluate the impact of smoking and screening status on lung cancer characteristics and clinical outcomes. According to the hospital-based lung cancer register database, a total of 2883 lung cancers were diagnosed in 2883 patients between January 2007 and September 2017, which were divided into four groups according to smoking and screening status. A comparison was performed in terms of clinical characteristics and outcomes of lung cancer between the four groups. For non-smokers, age, gender, screened status, tumor size, targeted therapy, and curative surgery were independent prognostic factors of overall survival for lung cancer subjects. However, screened status and gender were not significant prognostic factors for lung cancer survival in smokers with lung cancer. For the non-smoker group, about 4.9% of lung cancer subjects (N = 81) were detected by screening. However, only 0.97% of lung cancer subjects (N = 12) were detected by screening in smokers. This could be attributed to smokers’ negative attitudes and low socioeconomic status preventing LDCT lung cancer screening. In summary, our real-world data suggest that effectively encouraging smokers to be more willing to participate in lung cancer screening programs with screening allowance and educational training in the future is an important issue. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

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9 pages, 267 KiB

Open AccessArticle

Identification of Adolescents with Adiposities and Elevated Blood Pressure and Implementation of Preventive Measures Warrants the Use of Multiple Clinical Assessment Tools

by Hiba Bawadi, Manal Kassab, Abdel Hadi Zanabili and Reema Tayyem

J. Pers. Med. 2021, 11(9), 873; https://doi.org/10.3390/jpm11090873 - 31 Aug 2021

Cited by 2 | Viewed by 1782

Abstract

The burden of abdominal adiposity has increased globally, which is recognized as a key condition for the development of obesity-related disorders among youth, including type 2 diabetes, cardiovascular disease, and hypertension. High blood pressure (BP) and cardiovascular diseases increase the rates of premature mortality and morbidity substantially. Aims: to investigate the relation between abdominal adiposity and elevated BP among adolescent males in Jordan. Methods: Nationally representative sample of male adolescents was selected using multi-cluster sampling technique. Study sample included 1035 adolescent males aged 12 to 17 years. Multiple indicators were used to assess adiposity including waist circumference (WC) and total body fat (TF), truncal fat (TrF), and visceral fat (VF). Systolic blood pressure was measured to assess hypertension. Results: After adjusting for age, smoking status, and physical activity, the odds of having stage two hypertension increased 6, 7, and 8 times for adolescents who were on 90th percentile or above for Trf, VF, and WC, respectively. Conclusion: Elevated BP was significantly associated with total and abdominal adiposity among adolescent males in Jordan. Use of multiple clinical assessment tools is essential to assess abdominal obesity among adolescents. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

13 pages, 895 KiB

Open AccessArticle

Poor Prognosis of Diffuse Large B-Cell Lymphoma with Hepatitis C Infection

by Yu-Fen Tsai, Yi-Chang Liu, Ching-I Yang, Tzer-Ming Chuang, Ya-Lun Ke, Tsung-Jang Yeh, Yuh-Ching Gau, Jeng-Shiun Du, Hui-Ching Wang, Shih-Feng Cho, Chin-Mu Hsu, Pey-Fang Wu, Ching-I Huang, Chung-Feng Huang, Ming-Lung Yu, Chia-Yen Dai and Hui-Hua Hsiao

J. Pers. Med. 2021, 11(9), 844; https://doi.org/10.3390/jpm11090844 - 27 Aug 2021

Cited by 7 | Viewed by 2613

Abstract

Background: Hepatitis C virus (HCV) in diffuse large B-cell lymphoma (DLBCL) is associated with a higher prevalence and distinctive clinical characteristics and outcomes. Methods: A retrospective analysis of adult DLBCL patients from 2011 to 2015 was studied. Results: A total of 206 adult DLBCL were enrolled with 22 (10.7%) HCV-positive patients. Compared to HCV-negative patients, the HCV-positive group had a poor performance status (p = 0.011), lower platelet count (p = 0.029), and higher spleen and liver involvement incidences (liver involvement, p = 0.027, spleen involvement, p = 0.026), and they received fewer cycles of chemotherapy significantly due to morbidity and mortality (p = 0.048). Overall survival was shorter in HCV-positive DLBCL (25.3 months in HCV-positive vs. not reached (NR), p = 0.049). With multivariate analysis, poor performance status (p < 0.001), advanced stage (p < 0.001), less chemotherapy cycles (p < 0.001), and the presence of liver toxicity (p = 0.001) contributed to poor OS in DLBCL. Among HCV-positive DLBCL, the severity of liver fibrosis was the main risk factor related to death. Conclusion: Inferior survival of HCV-positive DLBCL was observed and associated with poor performance status, higher numbers of complications, and intolerance of treatment, leading to fewer therapy. Therefore, anti-HCV therapy, such as direct-acting antiviral agents, might benefit these patients in the future. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

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11 pages, 402 KiB

Open AccessFeature PaperArticle

Association of Ventilatory Disorders with Respiratory Symptoms, Physical Activity, and Quality of Life in Subjects with Prior Tuberculosis: A National Database Study in Korea

by Bumhee Yang, Hayoung Choi, Sun Hye Shin, Youlim Kim, Ji-Yong Moon, Hye Yun Park and Hyun Lee

J. Pers. Med. 2021, 11(7), 678; https://doi.org/10.3390/jpm11070678 - 19 Jul 2021

Cited by 8 | Viewed by 2374

Abstract

Tuberculosis (TB) survivors experience post-TB lung damage and ventilatory function disorders. However, the proportions of obstructive and restrictive ventilatory disorders as well as normal ventilation among subjects with prior TB are unknown. In addition, the impacts of ventilatory disorder and its severity on respiratory symptoms, physical activity limitations, and the quality of life in subjects with prior TB remain unclear. Subjects who participated in the Korean National Health and Nutritional Examination Survey 2007–2016 were enrolled in this study. We evaluated the impact of each ventilatory disorder and its severity on respiratory symptoms, physical activity limitations, and quality of life (measured by the EuroQoL five dimensions questionnaire [EQ-5D] index values) in subjects with prior TB. Among 1466 subjects with prior TB, 29% and 16% had obstructive ventilatory disorders and restrictive ventilatory disorders, respectively. Mild and moderate obstructive ventilatory disorders were not associated with respiratory symptoms, physical activity limitations, or EQ-5D index value compared with normal ventilation; however, severe obstructive ventilatory disorders were associated with more respiratory symptoms (adjusted odds ratio [aOR] = 13.62, 95% confidence interval [CI] = 4.64–39.99), more physical activity limitation (aOR = 218.58, 95% CI = 26.82–1781.12), and decreased EQ-5D index (adjusted coefficient = −0.06, 95% CI = (−0.12–−0.10) compared with normal ventilation. Mild restrictive ventilatory disorders were associated with more respiratory symptoms (aOR = 2.10, 95% CI = 1.07–4.14) compared with normal ventilation, while moderate (aOR = 5.71, 95% CI = 1.14–28.62) and severe restrictive ventilatory disorders (aOR = 9.17, 95% CI = 1.02–82.22) were associated with physical activity limitation compared with normal ventilation. In conclusion, among subjects with prior TB, 29% and 16% developed obstructive and restrictive ventilatory disorders, respectively. Severe obstructive ventilatory disorder was associated with more respiratory symptoms, more physical activity limitation, and poorer quality of life, while severe restrictive ventilatory disorder was associated with more physical activity limitations. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

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15 pages, 1916 KiB

Open AccessArticle

Decreased Tongue Pressure Associated with Aging, Chewing and Swallowing Difficulties of Community-Dwelling Older Adults in Taiwan

by Hsiu-Yueh Liu, Jen-Hao Chen, Kun-Jung Hsu, Ching-Teng Yao, Ping-Ho Chen, Szu-Yu Hsiao and Chun-Li Lin

J. Pers. Med. 2021, 11(7), 653; https://doi.org/10.3390/jpm11070653 - 11 Jul 2021

Cited by 11 | Viewed by 4172

Abstract

Personalized tongue pressure (TP) training focuses on improving swallowing. This study aims to establish the TP values of different age levels and compare changes between different swallowing status among community-dwelling elders. In this cross-sectional study, 1000 participants, aged 60 years old and above, were recruited from community care centers. All participants were classified into non chewing and/or swallowing difficulties (NCSD) and with chewing and/or swallowing difficulties (CSD) groups and their diseases and dieting status were recorded using a structured questionnaire. A disposable oral probe was used to measure TP by asking participants to compress it against the hard palate with maximum voluntary effort. Among 1000 elders, 63.10% had CSD and their TP (from 31.76 to 18.20 kPa) was lower than the NCSD group (from 33.56 to 24.51 kPa). Both groups showed the same tendency for TP decline with increasing age. Decline of TP makes CSD elderly have a poor appetite, eat a soft or liquid diet, and take longer to eat a meal (all p < 0.050). The secondary risk factor dominating TP decline for NCSD and CSD elders is having an education level less than primary school and an abnormal eating assessment, respectively. Our results demonstrated that TP decline has a significant relationship with age changes. Education level and an abnormal eating assessment score are closely associated with TP decline. A series of TP values can be used as a reference indicator of personalized medicine during the aging process among community-dwelling older adults. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

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19 pages, 2141 KiB

Open AccessArticle

Glycosylation of IgG Associates with Hypertension and Type 2 Diabetes Mellitus Comorbidity in the Chinese Muslim Ethnic Minorities and the Han Chinese

by Xiaoni Meng, Manshu Song, Marija Vilaj, Jerko Štambuk, Mamatyusupu Dolikun, Jie Zhang, Di Liu, Hao Wang, Xiaoyu Zhang, Jinxia Zhang, Weijie Cao, Ana Momčilović, Irena Trbojević-Akmačić, Xingang Li, Deqiang Zheng, Lijuan Wu, Xiuhua Guo, Youxin Wang, Gordan Lauc and Wei Wang

J. Pers. Med. 2021, 11(7), 614; https://doi.org/10.3390/jpm11070614 - 29 Jun 2021

Cited by 14 | Viewed by 3713

Abstract

Objectives: Hypertension and type 2 diabetes mellitus comorbidity (HDC) is common, which confers a higher risk of cardiovascular disease than the presence of either condition alone. Describing the underlying glycomic changes of immunoglobulin G (IgG) that predispose individuals to HDC may help develop novel protective immune-targeted and anti-inflammatory therapies. Therefore, we investigated glycosylation changes of IgG associated with HDC. Methods: The IgG N-glycan profiles of 883 plasma samples from the three northwestern Chinese Muslim ethnic minorities and the Han Chinese were analyzed by ultra-performance liquid chromatography instrument. Results: We found that 12 and six IgG N-glycan traits showed significant associations with HDC in the Chinese Muslim ethnic minorities and the Han Chinese, respectively, after adjustment for potential confounders and false discovery rate. Adding the IgG N-glycan traits to the baseline models, the area under the receiver operating characteristic curves (AUCs) of the combined models differentiating HDC from hypertension (HTN), type 2 diabetes mellitus (T2DM), and healthy individuals were 0.717, 0.747, and 0.786 in the pooled samples of Chinese Muslim ethnic minorities, and 0.828, 0.689, and 0.901 in the Han Chinese, respectively, showing improved discriminating performance than both the baseline models and the glycan-based models. Conclusion: Altered IgG N-glycan profiles were shown to associate with HDC, suggesting the involvement of inflammatory processes of IgG glycosylation. The alterations of IgG N-glycome, illustrated here for the first time in HDC, demonstrate a biomarker potential, which may shed light on future studies investigating their potential for monitoring or preventing the progression from HTN or T2DM towards HDC. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

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12 pages, 822 KiB

Open AccessArticle

The Impact of SARS-CoV-2 Pandemic on the New Cases of T1DM in Children. A Single-Centre Cohort Study

by Anca Andreea Boboc, Carmen Nicoleta Novac, Maria Teodora Ilie, Mara Ioana Ieșanu, Felicia Galoș, Mihaela Bălgrădean, Elena Camelia Berghea and Marcela Daniela Ionescu

J. Pers. Med. 2021, 11(6), 551; https://doi.org/10.3390/jpm11060551 - 13 Jun 2021

Cited by 28 | Viewed by 2782

Abstract

Type 1 diabetes mellitus (T1DM) represents one of the most frequent chronic illnesses affecting children. The early diagnosis of this disease is crucial, as it plays a key role in preventing the development of a life-threatening acute complication: diabetic ketoacidosis. The etiopathogenetic role of viral infections has long been suggested and emerging data are pointing towards a complex bidirectional relationship between diabetes and COVID-19. The aim of this study is to assess the impact of the COVID-19 pandemic on the incidence and severity of new T1DM cases in children in Romania. We analyzed the differences between a group of 312 patients diagnosed with T1DM in the period 2003–2019 and a group of 147 children diagnosed during the pandemic. The data were investigated using statistical analysis of a series of relevant variables. The total number of newly diagnosed T1DM increased by 30.08% in the period March 2020–February 2021 compared to the previous years. The patients in the pandemic group had a higher mean age at the onset of T1DM, were less frequently living in an urban area, and presented a higher mean value of HbA1c. Diabetic ketoacidosis at the onset of T1DM was 67.40% more frequent, and a higher percentage of these patients presented with a severe form. The duration of T1DM symptoms did not differ significantly between the two groups. A number of 8 patients associated SARS-CoV-2 infection at the time of T1DM diagnosis. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

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12 pages, 242 KiB

Open AccessArticle

Dental Treatment Needs and Related Risk Factors among School Children with Special Needs in Taiwan

by Szu-Yu Hsiao, Ping-Ho Chen, Shan-Shan Huang, Cheng-Wei Yen, Shun-Te Huang, Shu-Yuan Yin and Hsiu-Yueh Liu

J. Pers. Med. 2021, 11(6), 452; https://doi.org/10.3390/jpm11060452 - 23 May 2021

Cited by 5 | Viewed by 2765

Abstract

The purpose of this study was to assess dental treatment needs (TNs) and related risk factors of children with disabilities (CD). This cross-sectional study recruited 484 CD, 6 to 12 years of age, from 10 special education schools in Taiwan. Dental status and TNs were examined and evaluated by well-trained dentists and based on the criteria set by the World Health Organization (1997). The results indicated that 61.78% required restorative dental treatment due to their dental caries. On average, each participant had 2.72 teeth that required treatment, and 6.38 surfaces required restoration. One-quarter of the participants (24.79%) required 1- or 2-surface restoration, and one out of three (36.98%) had more complex TNs (including 3 or more surfaces to be filled, pulp care, extraction, and more specialized care). The significant risk factors associated with restorative TNs among CD were those whose parents had lower socioeconomic status, frequent sweets intake, insufficient tooth-brushing ability, and poor oral health. Most of the CD had extensive unmet TNs for their caries and required complex treatment to recover the function of their teeth. Encouraging parents/caregivers to take their children for dental treatment, promoting awareness of the importance of dental hygiene, giving assistance to brushing their teeth after eating, and controlling and/or modifying sweet diet habits are necessary to reduce CD’s dental caries, especially those with lower socioeconomic status parents/caregivers. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

13 pages, 1976 KiB

Open AccessArticle

Sex-Specific Association of Uric Acid and Kidney Function Decline in Taiwan

by Po-Ya Chang, Yu-Wei Chang, Yuh-Feng Lin and Hueng-Chuen Fan

J. Pers. Med. 2021, 11(5), 415; https://doi.org/10.3390/jpm11050415 - 15 May 2021

Cited by 9 | Viewed by 3381

Abstract

An elevated serum urate concentration is associated with kidney damage. Men’s uric acid levels are usually higher than women’s. However, postmenopausal women have a higher risk of gout than men, and comorbidities are also higher than in men. This study examined the sex differences in the relationship between hyperuricemia and renal progression in early chronic kidney disease (CKD) and non-CKD, and further examined the incidence of CKD in non-CKD populations among patients over 50 years of age. We analyzed 1856 women and 1852 men participating in the epidemiology and risk factors surveillance of the CKD database. Women showed a significantly higher risk of renal progression and CKD than men within the hyperuricemia group. After adjusting covariates, women, but not men resulted in an hazard ratio (HR) for developing renal progression (HR = 1.12; 95% CI 1.01–1.24 in women and HR = 1.03; 95% CI 0.93–1.13 in men) and CKD (HR = 1.11; 95% CI 1.01–1.22 in women and HR = 0.95; 95% CI 0.85–1.05 in men) for each 1 mg/dL increase in serum urate levels. The association between serum urate levels and renal progression was stronger in women. Given the prevalence and impact of kidney disease, factors that impede optimal renal function management in women and men must be identified to provide tailored treatment recommendations. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

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10 pages, 1777 KiB

Open AccessArticle

Risk of Typical Diabetes-Associated Complications in Different Clusters of Diabetic Patients: Analysis of Nine Risk Factors

by Michael Leutner, Nils Haug, Luise Bellach, Elma Dervic, Alexander Kautzky, Peter Klimek and Alexandra Kautzky-Willer

J. Pers. Med. 2021, 11(5), 328; https://doi.org/10.3390/jpm11050328 - 22 Apr 2021

Cited by 12 | Viewed by 2871

Abstract

Objectives: Diabetic patients are often diagnosed with several comorbidities. The aim of the present study was to investigate the relationship between different combinations of risk factors and complications in diabetic patients. Research design and methods: We used a longitudinal, population-wide dataset of patients with hospital diagnoses and identified all patients (n = 195,575) receiving a diagnosis of diabetes in the observation period from 2003–2014. We defined nine ICD-10-codes as risk factors and 16 ICD-10 codes as complications. Using a computational algorithm, cohort patients were assigned to clusters based on the risk factors they were diagnosed with. The clusters were defined so that the patients assigned to them developed similar complications. Complication risk was quantified in terms of relative risk (RR) compared with healthy control patients. Results: We identified five clusters associated with an increased risk of complications. A combined diagnosis of arterial hypertension (aHTN) and dyslipidemia was shared by all clusters and expressed a baseline of increased risk. Additional diagnosis of (1) smoking, (2) depression, (3) liver disease, or (4) obesity made up the other four clusters and further increased the risk of complications. Cluster 9 (aHTN, dyslipidemia and depression) represented diabetic patients at high risk of angina pectoris “AP” (RR: 7.35, CI: 6.74–8.01), kidney disease (RR: 3.18, CI: 3.04–3.32), polyneuropathy (RR: 4.80, CI: 4.23–5.45), and stroke (RR: 4.32, CI: 3.95–4.71), whereas cluster 10 (aHTN, dyslipidemia and smoking) identified patients with the highest risk of AP (RR: 10.10, CI: 9.28–10.98), atherosclerosis (RR: 4.07, CI: 3.84–4.31), and loss of extremities (RR: 4.21, CI: 1.5–11.84) compared to the controls. Conclusions: A comorbidity of aHTN and dyslipidemia was shown to be associated with diabetic complications across all risk-clusters. This effect was amplified by a combination with either depression, smoking, obesity, or non-specific liver disease. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

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Review

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16 pages, 976 KiB

Open AccessReview

Implementing Personalized Medicine in COVID-19 in Andalusia: An Opportunity to Transform the Healthcare System

by Joaquín Dopazo, Douglas Maya-Miles, Federico García, Nicola Lorusso, Miguel Ángel Calleja, María Jesús Pareja, José López-Miranda, Jesús Rodríguez-Baño, Javier Padillo, Isaac Túnez and Manuel Romero-Gómez

J. Pers. Med. 2021, 11(6), 475; https://doi.org/10.3390/jpm11060475 - 26 May 2021

Cited by 16 | Viewed by 5474

Abstract

The COVID-19 pandemic represents an unprecedented opportunity to exploit the advantages of personalized medicine for the prevention, diagnosis, treatment, surveillance and management of a new challenge in public health. COVID-19 infection is highly variable, ranging from asymptomatic infections to severe, life-threatening manifestations. Personalized medicine can play a key role in elucidating individual susceptibility to the infection as well as inter-individual variability in clinical course, prognosis and response to treatment. Integrating personalized medicine into clinical practice can also transform health care by enabling the design of preventive and therapeutic strategies tailored to individual profiles, improving the detection of outbreaks or defining transmission patterns at an increasingly local level. SARS-CoV2 genome sequencing, together with the assessment of specific patient genetic variants, will support clinical decision-makers and ultimately better ways to fight this disease. Additionally, it would facilitate a better stratification and selection of patients for clinical trials, thus increasing the likelihood of obtaining positive results. Lastly, defining a national strategy to implement in clinical practice all available tools of personalized medicine in COVID-19 could be challenging but linked to a positive transformation of the health care system. In this review, we provide an update of the achievements, promises, and challenges of personalized medicine in the fight against COVID-19 from susceptibility to natural history and response to therapy, as well as from surveillance to control measures and vaccination. We also discuss strategies to facilitate the adoption of this new paradigm for medical and public health measures during and after the pandemic in health care systems. Full article

(This article belongs to the Special Issue Personalized Medicine in Epidemics)

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