In Practice

Clinical management of COVID-19: Experiences of the COVID-19 epidemic from Groote Schuur Hospital, Cape Town, South Africa

M M Mendelson, L Boloko, A Boutall, L Cairncross, G Calligaro, C Coccia, JA Dave, M de Villiers, S Dlamini, P Frankenfeld, P Gina, M V Gule, J Hoare, R Hofmeyr, M Hsiao, I Joubert, T Kahn, R Krause, A Kroopman, D Levin, D Maughan, S Mazondwa, G Meintjes, R Nordien, N Ntusi, N Papavarnavas, J Peter, H Pickard, P Raubenheimer, Q Said-Hartley, P Singh, S Wasserman, on behalf of the Groote Schuur Hospital

Abstract


The SARS-CoV-2 pandemic has presented clinicians with an enormous challenge in managing a respiratory virus that is not only capable of causing severe pneumonia and acute respiratory distress syndrome, but also multisystem disease. The extraordinary pace of clinical research, and particularly the surge in adaptive trials of new and repurposed treatments, have provided rapid answers to questions
of whether such treatments work, and has resulted in corticosteroids taking centre stage in the management of hospitalised patients requiring oxygen support. Some treatment modalities, such as the role of anticoagulation to prevent and treat potential thromboembolic complications, remain controversial, as does the use of high-level oxygen support, outside of an intensive care unit setting. In this paper, we describe the clinical management of COVID-19 patients admitted to Groote Schuur Hospital, a major tertiary level hospital at the epicentre of South Africa’s SARS-CoV-2 epidemic during its first 4 months.


Authors' affiliations

M M Mendelson, Division of Infectious Diseases and HIV Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

L Boloko, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

A Boutall, Division of General Surgery, Faculty of Health Sciences, University of Cape Town, South Africa

L Cairncross, Division of General Surgery, Faculty of Health Sciences, University of Cape Town, South Africa

G Calligaro, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Division of Pulmonology, Faculty of Health Sciences, University of Cape Town, South Africa

C Coccia, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

JA Dave, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Division of Endocrinology, Faculty of Health Sciences, University of Cape Town, South Africa

M de Villiers, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

S Dlamini, Division of Infectious Diseases and HIV Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

P Frankenfeld, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

P Gina, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

M V Gule, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

J Hoare, Department of Psychiatry, Faculty of Health Sciences, University of Cape Town, South Africa

R Hofmeyr, Department of Anaesthesia and Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

M Hsiao, Division of Medical Virology, Department of Pathology, University of Cape Town and Groote Schuur Hospital Complex, National Health Laboratory Service, Cape Town, South Africa

I Joubert, Division of Critical Care Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

T Kahn, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

R Krause, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

A Kroopman, Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

D Levin, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Division of Gastroenterology, Faculty of Health Sciences, University of Cape Town, South Africa

D Maughan, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

S Mazondwa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

G Meintjes, Division of Infectious Diseases and HIV Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

R Nordien, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

N Ntusi, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

N Papavarnavas, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

J Peter, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Division of Allergy and Clinical Immunology, Faculty of Health Sciences, University of Cape Town, South Africa

H Pickard, Division of General Surgery, Faculty of Health Sciences, University of Cape Town, South Africa

P Raubenheimer, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

Q Said-Hartley, Department of Radiology, Faculty of Health Sciences, University of Cape Town, South Africa

P Singh, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

S Wasserman, Division of Infectious Diseases and HIV Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

on behalf of the Groote Schuur Hospital, Groote Schuur Hospitals COVID-19 Response Team

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

Article History

Date submitted: 2020-08-26
Date published: 2020-08-26

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