Anti-inflammatory drugs may help keep novel coronavirus in check; mornings not ideal for fever screening

The following is a brief roundup of some of the latest scientific studies on the novel coronavirus and efforts to find treatments and vaccines for COVID-19, the illness caused by the virus.

Anti-inflammatories may keep coronavirus from replicating

Researchers in Spain using computer techniques have analyzed 6,466 approved drugs and identified seven that might inhibit the main enzyme that helps the coronavirus to replicate, referred to as M-pro.

The approach is already being tested via trials of the HIV antiretroviral medications lopinavir and ritonavir. Two of the seven newly identified drugs, both anti-inflammatory medications, have been selected by a group of academic researchers for early-stage laboratory tests, according to a report published on Wednesday in the International Journal of Molecular Sciences.

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The two are celecoxib, sold by Pfizer Inc for arthritis pain under the brand name Celebrex, and carprofen, used for pets under several brand names, including Rimadyl from Zoetis Inc. The researchers say the molecular structures of these drugs could be used as starting points for developing derivatives with more potent effects against the coronavirus.

Morning fever screenings may be misleading

As businesses and cities reopen, screening people for fever when they arrive in the morning at work or school is likely to be widely used to help prevent coronavirus spread. But "morning may be the worst time" to screen for fevers, researchers say.

They draw this conclusion from data collected from more than 300,000 people during studies of flu outbreaks in earlier years.

"Fever-range temperatures ...were rarest during mornings, and were about half as common during mornings as during evenings in periods of high influenza activity," they report in a paper published on Tuesday without peer review on the medRxiv preprint server.

"The results suggest that morning temperature measurements could miss many febrile disease cases," they said.

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Kidney disease yet another risk factor for more severe COVID-19

People with chronic kidney disease should take extra precautions to stay safe from the novel coronavirus, new data from New York City suggest. Doctors analyzed medical records on nearly 3,400 patients who had tested positive for the coronavirus, including 210 with chronic kidney disease.

They found that those with poor kidney function were more than twice as likely to require mechanical breathing assistance and more than twice as likely to die.

"This tendency was consistent for each age group," they reported on Tuesday in the journal International Urology and Nephrology.

Unfortunately, they did not have enough information to tell whether the risks increased as the stage of patients' kidney disease worsened.

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Thickened blood in COVID-19 patients contributes to clotting problems

Doctors are seeing dramatically increased rates of blood-clot-related complications in patients infected with the novel coronavirus. It appears that the virus injures the lining of blood vessels - the endothelium - leading blood to clot as it flows past the damage.

A small study has now found that blood in critically ill COVID-19 patients appears to be thicker than normal. The condition, called hyperviscosity, is known to damage the endothelium and increase the risk for clots, researchers reported on Monday in The Lancet medical journal.

They are "actively exploring" whether COVID-19 patients with hyperviscosity will benefit from plasma exchange, an effective treatment for hyperviscosity in other illnesses.

Clot removal more difficult in coronavirus patients with stroke

When someone suffers a stroke because an artery to the brain is blocked by a blood clot, or thrombus, doctors can often mechanically remove it if the problem is diagnosed early, restoring blood flow to the brain.

But doctors in New York City are warning that when such "ischemic strokes" occur in COVID-19 patients, mechanical removal may be more challenging.

Compared to more typical stroke patients requiring mechanical thrombectomy, COVID-19 patients had more clots - and those clots tended to break into pieces, making them harder to remove.

"These patients present unique challenges that make successful revascularization difficult," they reported on Monday in the Journal of NeuroInterventional Surgery.