Clinical management of COVID-19: Experiences of the COVID-19 epidemic from Groote Schuur Hospital, Cape Town, South Africa
Marc Mendelson, Linda Boloko, Adam Boutall, Lydia Cairncross, Greg Calligaro, Cecilia Coccia, Joel A. Dave, Marietjie de Villiers, Sipho Dlamini, P Frankenfeld, P Gina, M. V. Gule, Jacqueline Hoare, Ross Hofmeyr, Marvin Hsiao, I Joubert, T Kahn, René Krause, A Kroopman, Dion Levin, Deborah Maughan, Simthandile Mazondwa, Graeme Meintjes, R Nordien, Ntobeko Ntusi, Nectarios Papavarnavas, Jonny Peter, H Pickard, P Raubenheimer, Qonita Said-Hartley, Prasun Singh, Sean Wasserman
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.