Mustafa, FatimaGiles, RachelPepper, Michael Sean2021-09-082021-09-082020-12Mustafa, F., Giles, R. & Pepper, M.S. 2020, 'Rapid evolution of our understanding of the pathogenesis of COVID-19 – implications for therapy', South African Medical Journal, vol. 110, no. 12, pp. 1180-1185.0256-9574 (print)2078-5135 (online)10.7196/SAMJ.2020.v110i12.15328http://hdl.handle.net/2263/81717COVID-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).en© 2020 Health & Medical Publishing Group. This work is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0).COVID-19 pandemicCoronavirus disease 2019 (COVID-19)Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)Cytokine release syndrome (CRS)Acute respiratory distress syndrome (ARDS)Article