Little was known of SARS-CoV-2 a few months ago. However, since then this highly contagious virus has spread worldwide and has created enormous turmoil all around the world. It has caused major devastation to health, economies, education and has percolated through almost all aspects of daily living. Health systems have been stretched or overwhelmed in many parts of the world. As of writing, there are over 8.2 million infections worldwide and over 400,000 have died. In South Africa, currently there are 83,000 infections with a mortality over 1700. Currently the health systems in South Africa seem to be holding up. However, as the protracted lockdown ends there is a widespread belief that there is going to be a significant spike in new infections and concerns whether our health systems will cope.
Although it is uncertain how COVID-19 will progress in South Africa, it is important to collect accurately as much data as possible and analyse this over the coming months so that we could get insights on how to manage this pandemic or for that matter any future pandemics. This journal strongly supports this initiative and has endeavoured to publish the clinical data particularly in relation to the varying aspects of the COVID-19 pandemic in South Africa. To this end, Wits Journal of Clinical Medicine was the first clinical journal in South Africa to publish in April of this year a special issue dedicated to COVID-19 infection in South Africa. As part of the educational initiative on COVID-19, the journal also arranged for a webinar recently which highlighted several aspects of testing, preparedness, treatment, COVID-19 in Africa and behaviour modification in handling the pandemic in South Africa.
This journal's main focus is to publish research in the field of clinical medicine and the current issue presents original work. However, the unprecedented impact of COVID-19 and the uniqueness of its presentation has guided the editorial team to publish on many health-related aspects of COVID-19 in South Africa. As the pandemic has continued in South Africa, albeit at a slightly flattened curve, we are continually challenged as to how it will affect health and health systems and therefore collection and careful analysis of data of patients who are positive for COVID-19 are important. Thus, in this issue of the journal, the lead article highlights the clinical findings and outcomes of the first 100 patients admitted to a large public hospital in South Africa. There are some similarities with regard to demographics of the disease worldwide, but the authors do provide insight into some of the early findings related to HIV patients infected with COVID-19.
There have been a number of reports in the literature detailing psychopathological sequelae of COVID-19 related to social isolation, limitations on physical activity and emotional distress related to the fears of infection. Thus, Subramaney et al. highlight some of these psychiatric conditions attributed to COVID-19 infection in the South African context, which may allow for earlier diagnosis and more effective treatment. This issue also covers aspects of respiratory failure in COVID-19 and current strategies for its management as well as some early data in South Africa of the impact of COVID-19 in patients with renal disease. A review of neurological disease associated with COVID-19 is also presented in this issue. The impact of the lockdown in March of this year on primary care services, family planning and transplant services is also highlighted in the current issue.
I thank the editorial team and Wits press for publishing this issue timeously so soon after the Special COVID issue in April.
Pravin Manga
Editor-in-Chief
Wits Journal of Clinical Medicine