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Publication: Rapid evolution of our understanding of the pathogenesis of COVID-19 – implications for therapy
Mustafa, F. ; Giles, R. ; Pepper, M.S.
Mustafa, F.
Giles, R.
Pepper, M.S.
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Abstract
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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Date
2020-10-23
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Publisher
South African Medical Journal (SAMJ)
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Keywords
COVID-19,Cytokine release syndrome,ARDS,Comorbidities,Therapeutic strategies
Citation
Mustafa F, Giles R, Pepper MS. Rapid evolution of our understanding of the pathogenesis of COVID-19: Implications for therapy. S Afr Med J.