Review

Rapid evolution of our understanding of the pathogenesis of COVID-19: Implications for therapy

F Mustafa, R Giles, M S Pepper

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 so 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).


Authors' affiliations

F Mustafa, Institute for Cellular and Molecular Medicine, Department of Immunology; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, South Africa; Department of Paediatrics, Faculty of Health Sciences, University of Pretoria, South Africa

R Giles, Institute for Cellular and Molecular Medicine, Department of Immunology; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, South Africa

M S Pepper, Institute for Cellular and Molecular Medicine, Department of Immunology; SAMRC Extramural Unit for Stem Cell Research and Therapy, Faculty of Health Sciences, University of Pretoria, South Africa

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Keywords

ARS-CoV-2; COVID-19; Cytokine release syndrome; ARDS; Comorbidities; Therapeutic strategies

Cite this article

South African Medical Journal 0;0(0):.

Article History

Date submitted: 2020-10-23
Date published: 2020-10-23

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