Title:
COVID-19 and the rationale for pharmacotherapy: a South African perspective
Authors:
Guy Richards, Mervyn Mer, Gunther Schleicher & Sarah Stacey
Affiliations:
University of the Witwatersrand & Wits Donald Gordon Medical Center
Published:
Wits Journal of Clinical Medicine, Volume 2, Number Si1, April 2020, pp. 11-18
Available: https://journals.co.za/content/journal/10520/EJC-1c8ca3e2f3
Abstract:
SARS-CoV-2 is a pathogen phylogenetically similar to two previous zoonotic coronaviruses: severe acute respiratory syndrome coronavirus 2002 (SARS-CoV-1) and the Middle East respiratory syndrome coronavirus 2012 (MERS-CoV), the case fatality rates (CFRs) of which were 7%–10% and 30%, respectively. While the CFR of the current pandemic is considerably less than these prior epidemics (approximately 1%–2% of confirmed cases), the sheer numbers of patients globally that have contracted the disease has meant that the overall mortality has far outstripped that of the other coronavirus infections. This mortality seems to considerably vary from country to country, and this has not been fully explained. The real-time numbers infected and the mortality rates can be accessed at the following site: https://www.worldometers.info/ coronavirus/. The low rates in areas such as South Korea are probably due to the extensive testing that has been performed to date, increasing the denominator by including asymptomatic or mildly symptomatic patients; however, other factors may be involved such as the overall age of the populations concerned and possibly the effect of vitamin D (i.e. sunlight) on the viral receptor ACE2 in the lung.