Pharmacogenomics at the post-pandemic: If not now, then when?

Abstract

The emergence of Coronavirus disease 2019 (COVID-19) has changed the world in an irrevocable direction. The changes have affected all vital sectors, including finance, education, communications, research, and, undoubtedly, the medical practice. Every field related to human health explored how to escalate its performance and updated its research priorities to respond to the situation imposed by the devastating pandemic. Pharmacogenomics (PGx) is not an exception. Multiple researchers in the field investigated the available PGx information related to medications used in COVID-19 management, and various reviews have appeared since late 2020 till today (Takahashi et al., 2020; Badary, 2021; Fricke-Galindo and FalfánValencia, 2021; Biswas et al., 2022; Franczyk et al., 2022). Most of these reviews concluded that the evidence of the pharmacogenomic interactions for drugs used in the new Coronavirusinduced severe respiratory syndrome (SARS-CoV2) infection management is not strong enough to warrant testing. Herein, there are common findings among these reviews that deserve highlighting. Moreover, extrapolating these findings into populations underrepresented in PGx research that were challenged by the pandemic, equally to all other populations, can reflect on future practices. The following insights explore the probability of the situation imposed by COVID-19 being an opportunity, rather than a threat, for largescale PGx adoption. The earliest publication of SARS-CoV2 treatment PGx was a literature review by Takahashi and colleagues (Takahashi et al., 2020), which was available online in August 2020. In their work, the authors listed the available therapeutic options for SARS-CoV2 infection used in the US healthcare system and in interventional clinical trials registered on ClinicalTrials.gov at the time of publication. The authors reviewed the pharmacogenetic biomarkers found to be associated with these drugs. None of the studied drugs had approved PGx-guided dosing guidelines, and few had moderate to low significance PGx associations. The illustrated candidate response and toxicity biomarkers were retrieved from previous research in diseases other than COVID-19. The authors highlighted that no PGx data is available from SARS-CoV2 patients yet.

Keywords: Pharmacogenomics (PGx), COVID-19, Precision Medicine, Cost-effective, Understudied groups