key: cord-1035687-timk27h7
authors: Tricarico, Gerardo; Travagli, Valter
title: COVID-19: Precision Medicine and Vascular Endothelium
date: 2021-04-19
journal: Mayo Clin Proc
DOI: 10.1016/j.mayocp.2021.04.004
sha: 704c6a5c79511bc25f6f62e56603fa69946249a0
doc_id: 1035687
cord_uid: timk27h7

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Authors: Gerardo TRICARICO, MD 1,2 and Valter TRAVAGLI, PharmD 3 Disclosure: G. Tricarico and V. Travagli declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

To the Editor: We read with care and interest the original article from Pereira et al. about the development of a precision medicine approach to the COVID-19 pandemic. 1 We appreciate very much the specialist explanation about the demographic (such as age, race, ethnicity, sex) and biological variables (such as ACE2 expression, immune regulation, body mass index and genetics) that may characterize the high-risk patient and they can serve for optimizing hospitalization, vaccination and targeted drug therapy.

However, "predictive algorithms may help in individualizing targeted therapy including hospitalization and assist in the logistics of vaccine administration" only if all key factors are included. In our opinion, it is of paramount importance to introduce the vascular endothelium into the discussion. 2 In fact, endothelial damage to various organs were highlighted by autopsy outcomes 3 

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