Mustafa, F.Giles, R.Pepper, M.S.2024-06-022024-06-022020-10-23Mustafa F, Giles R, Pepper MS. Rapid evolution of our understanding of the pathogenesis of COVID-19: Implications for therapy. S Afr Med J.10.7196/SAMJ.2020.v110i12.15328https://pubmed.ncbi.nlm.nih.gov/33403962/https://hdl.handle.net/11288/596197COVID-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).enAttribution 3.0 United Stateshttp://creativecommons.org/licenses/by/3.0/us/COVID-19Cytokine release syndromeARDSComorbiditiesTherapeutic strategiesArticleSouth African Medical Journal (SAMJ)