Many parts of the country have now entered into the third wave of COVID-19 infections. As a consequence, level 3 lockdown regulations have been imposed by the government. In many respects, this seems like Déjà vu of the first and second waves. Schools have been closed again, and many hospitals have seen large numbers of COVID-19 admissions and death rates related to the pandemic continue to rise.
Many wonder when this pandemic will end. There are some who speculate that COVID-19 will be with us for the foreseeable future as our vaccine rollout has been very slow and mired in controversy. Thus, our current strategy in combating the virus remains the same that we started with when the pandemic started i.e. masking, social distancing and sanitizing. Current evidence suggests that the majority of COVID-19 infections are caused by an aerosol- related infection. The most effective strategy in combating viral infection is thus adequate masking, social distancing and improving ventilation in closed spaces. In this issue of the journal, we introduce a new digital feature. This is in the form of a video interview titled “Conversations”, which highlight views and opinions of experts in their field. In the current issue, the guest expert Professor Francois Venter discusses many aspects of how to prevent COVID-19 infection, including the value of masking as well as some valuable insights into the vaccination strategies in South Africa.
As the COVID-19 pandemic continues to rage, the editorial board of the journal will continue to highlight research and reviews of the latest research in this field. In this issue of the journal, we publish two important reviews related to COVID-19. It is estimated that 10% of patients who survive COVID-19 infection continue to experience adverse symptoms weeks to sometimes many months after the initial onset of the illness. This has been termed the post-COVID syndrome or the COVID long haulers syndrome and more recently the post-acute COVID-19 sequelae (PACS). In this issue of the journal, Richards and colleagues highlight the subject of PACS and they discuss in detail the clinical presentation, pathophysiology and management of this difficult clinical problem.
Anticoagulation is an important strategy in the management of hospitalized patients with COVID-19. However, there has been a lot of debate and controversy on the type and dosage of anticoagulation required for these patients. Mhlana and Parker present an up-to-date review of the latest evidence regarding anticoagulation for patients hospitalized with COVID-19 and discuss the current evidence-based recommendations for anticoagulation in this group of patients.
There have been numerous reports over the past few years on the role of Vitamin D in health and more recently its use in the management of COVID-19 infection. Thus, the review by Bayat and Daya on the current role of Vitamin D on various aspects of health in this issue of the journal is timely.
Bone health is an important part of healthy living. Osteoporosis is common in this country. According to National Osteoporosis foundation of South Africa, 1 in 3 women and 1 in 5 men will possibly develop this disease within their lifetime, which means potentially between 4 and 6 million South Africans suffer from osteoporosis. Thus bisphosphonates form a cornerstone therapeutic modality in many osteoporotic patients. Although bisphosphonates continue to inhibit bone resorption after discontinuation, the length of discontinuation is unclear. Rukarwa and colleagues present interesting findings about the role of a drug holiday from bisphosphonate therapy in patients in their osteoporosis clinic and suggest strategies on how to manage patients receiving long-term bisphosphonate therapy.
The parathyroid gland is closely related to bone health. In one of the largest series of patients with primary hyperparathyroidism in South Africa, MacRobert et al. report on the prevalence of single gland versus multigland hyperparathyroidism and whether careful preoperative imaging can guide the surgeon in considering minimally invasive parathyroidectomy.
I take this opportunity to thank the many reviewers who have reviewed manuscripts for the journal. Their time and dedication is warmly appreciated by the editorial board.
Pravin Manga
Editor
Wits Journal of Clinical Medicine
