Abstract

MUSTAFA, F; GILES, R  and  PEPPER, M S. Rapid evolution of our understanding of the pathogenesis of COVID-19 - implications for therapy. SAMJ, S. Afr. med. j. [online]. 2020, vol.110, n.12, pp.1180-1185. ISSN 2078-5135.  http://dx.doi.org/10.7196/samj.2020.v110i12.15328.

COVID-19 severity appears to lie in its propensity to cause a hyperinflammatory response, attributed to the cytokine release syndrome (CRS) or 'cytokine storm', although the exact role of the CRS remains to be fully elucidated. Hyperinflammation triggers a hypercoagulable state, also thought to play a key role in COVID-19 pathogenesis. Disease severity is linked to age, sex and comorbid conditions, which in turn may be linked to oxidative stress and pre-existing depletion of nicotinamide adenine dinucleotide (NAD+). There is increasing evidence that the host genome may determine disease outcome. Since most information pertaining to COVID-19 has thus far been extrapolated from the 'global North', similar studies in African populations are warranted. Many studies are aimed at finding a therapeutic strategy based on scientific rationale. Some promising results have emerged, e.g. the use of corticosteroids in severe acute respiratory distress syndrome (ARDS).

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