Review Article

Phenome-wide association study and precision medicine of cardiovascular diseases in the post-COVID-19 era

Qian Cao1, Xin Du1, Xiao-yan Jiang1, Yuan Tian1, Chen-hao Gao1, Zi-yu Liu1, Ting Xu1, Xing-xing Tao1, Ming Lei1, Xiao-qiang Wang1, Lingyu Linda Ye1,2,3, Dayue Darrel Duan1,2,3,4
1 Center for Phenomics of Traditional Chinese Medicine, the Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou 646000, China
2 Institute of Integrated Chinese and Western Medicine, Southwest Medical University, Luzhou 646000, China
3 Key Laboratory of Autoimmune Diseases and Precision Medicie, People’s Hospital of Ningxia Hui Autonomous Region, Yinchuan 750001, China
4 The Department of Pharmacology, University of Nevada Reno School of Medicine, Reno, NV 89557, USA
Correspondence to: Lingyu Linda Ye: lye@swmu.edu.cn, Dayue Darrel Duan: dduan@swmu.edu.cn,
DOI: 10.1038/s41401-023-01119-1
Received: 7 April 2023
Accepted: 29 May 2023
Advance online: 2 August 2023

Abstract

SARS-CoV-2 infection causes injuries of not only the lungs but also the heart and endothelial cells in vasculature of multiple organs, and induces systemic inflammation and immune over-reactions, which makes COVID-19 a disease phenome that simultaneously affects multiple systems. Cardiovascular diseases (CVD) are intrinsic risk and causative factors for severe COVID-19 comorbidities and death. The wide-spread infection and reinfection of SARS-CoV-2 variants and the long-COVID may become a new common threat to human health and propose unprecedented impact on the risk factors, pathophysiology, and pharmacology of many diseases including CVD for a long time. COVID-19 has highlighted the urgent demand for precision medicine which needs new knowledge network to innovate disease taxonomy for more precise diagnosis, therapy, and prevention of disease. A deeper understanding of CVD in the setting of COVID-19 phenome requires a paradigm shift from the current phenotypic study that focuses on the virus or individual symptoms to phenomics of COVID-19 that addresses the inter-connectedness of clinical phenotypes, i.e., clinical phenome. Here, we summarize the CVD manifestations in the full clinical spectrum of COVID-19, and the phenome-wide association study of CVD interrelated to COVID-19. We discuss the underlying biology for CVD in the COVID-19 phenome and the concept of precision medicine with new phenomic taxonomy that addresses the overall pathophysiological responses of the body to the SARS-CoV-2 infection. We also briefly discuss the unique taxonomy of disease as Zheng-hou patterns in traditional Chinese medicine, and their potential implications in precision medicine of CVD in the post-COVID-19 era.
Keywords: COVID-19; cardiovascular disease; PheWAS; precision medicine; Traditional Chinese Medicine

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