001. Giuseppe Lippia, Mario Plebani and Brandon Michael Henry*. Cardiac Intensive Care Unit, The Heart Institute, Cincinnati Children’s Hospital Medical Center, OH, USA. Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis. Clinica Chimica Acta, 2020, 506, Pages: 145 - 148.

Background

      Coronavirus disease 2019 (COVID-19) is a novel infectious disease with lack of established laboratory markers available to evaluate illness severity. In this study, we investigate whether platelet count could differentiate between COVID-19 patients with or without severe disease. Additionally, we evaluate if thrombocytopenia is associated with severe COVID-19.

Methods

      An electronic search in Medline, Scopus and Web of Science was performed to identify studies reporting data on platelet count in COVID-19 patients. A meta-analysis was performed, with calculation of weighted mean difference (WMD) of platelet number in COVID-19 patients with or without severe disease and odds ratio (OR) of thrombocytopenia for severe form of COVID-19.

Results

      Nine studies with 1779 COVID-19 patients, 399 (22.4%) with severe disease, were included in the meta-analysis. The pooled analysis revealed that platelet count was significantly lower in patients with more severe COVID-19 (WMD −31 × 109/L; 95% CI, from −35 to −29 × 109/L). A subgroup analysis comparing patients by survival, found an even lower platelet count was observed with mortality (WMD, −48 × 109/L; 95% CI, −57 to −39 × 109/L. In the four studies (n = 1427) which reported data on rate of thrombocytopenia, a low platelet count was associated with over fivefold enhanced risk of severe COVID-19 (OR, 5.1; 95% CI, 1.8–14.6).

Conclusions

      Low platelet count is associated with increased risk of severe disease and mortality in patients with COVID-19, and thus should serve as clinical indicator of worsening illness during hospitalization.

Keywords: Platelets, Thrombocytopenia, Coronavirus, COVID-19.

002. Suyash Pant, Meenakshi Singh, V. Ravichandiran, U. S. N. Murty & Hemant Kumar Srivastava*. Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research Guwahati, Guwahati, Assam, India. Peptide-like and small-molecule inhibitors against Covid-19. Journal of Biomolecular Structure and Dynamics, 2020.

      Coronavirus disease strain (SARS-CoV-2) was discovered in 2019, and it is spreading very fast around the world causing the disease Covid-19. Currently, more than 1.6 million individuals are infected, and several thousand are dead across the globe because of Covid-19. Here, we utilized the in-silico approaches to identify possible protease inhibitors against SARS-CoV-2. Potential compounds were screened from the CHEMBL database, ZINC database, FDA approved drugs and molecules under clinical trials. Our study is based on 6Y2F and 6W63 co-crystallized structures available in the protein data bank (PDB). Seven hundred compounds from ZINC/CHEMBL databases and fourteen hundred compounds from drug-bank were selected based on positive interactions with the reported binding site. All the selected compounds were subjected to standard-precision (SP) and extra-precision (XP) mode of docking. Generated docked poses were carefully visualized for known interactions within the binding site. Molecular mechanics-generalized born surface area (MM-GBSA) calculations were performed to screen the best compounds based on docking scores and binding energy values. Molecular dynamics (MD) simulations were carried out on four selected compounds from the CHEMBL database to validate the stability and interactions. MD simulations were also performed on the PDB structure 6YF2F to understand the differences between screened molecules and co-crystallized ligand. We screened 300 potential compounds from various databases, and 66 potential compounds from FDA approved drugs. Cobicistat, ritonavir, lopinavir, and darunavir are in the top screened molecules from FDA approved drugs. The screened drugs and molecules may be helpful in fighting with SARS-CoV-2 after further studies.

Keywords: Covid-19, MD Simulations, Virtual Screening, Drug Repurposing.

003. Addi, Rachid Ait; Benksim, Abdelhafid; Amine, Mohamed; Cherkaoui, Mohamed. Cardiac Asymptomatic COVID-19 Infection Management: The Key to Stop COVID-19. Journal of Clinical & Experimental Investigations, 2020, 11(3), Pages: 1-2.

      The COVID-19 disease, emerged in December 2019, has spread rapidly, with new cases confirmed in multiple countries. Many efforts to contain the virus are ongoing, such as containment, individual measures of protection, the authorization of use of some drugs as chloquorine in some countries. Also, it has been known that symptomatic and asymptomatic people whom are infected by COVID-19 have the same contagiousness which expose a far greater portion of the population to virus and increase the late diagnosis and thereafter enhance COVID-19 mortality. Thereafter, it is fundamental to review our COVID-19 screening approach and enlarge COVID-19 testing to the general population by using rapid testing appliances such as rapid SARS-CoV-2 IgG-IgM combined antibody since another appliance more efficient will be performed.

Keywords: COVID-19, pandemic, screening, diagnosis.

004. Ali A.Asadi-Pooya* and Leila Simani. Cardiac Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Central nervous system manifestations of COVID-19: A systematic review. Journal of the Neurological Sciences, 2020, 413, Pages: 116832.

Objectives

      In this systematic review, we will discuss the evidence on the occurrence of central nervous system (CNS) involvement and neurological manifestations in patients with COVID-19.

Methods

      MEDLINE (accessed from PubMed) and Scopus from December 01, 2019 to March 26, 2020 were systematically searched for related published articles. In both electronic databases, the following search strategy was implemented and these key words (in the title/abstract) were used: “COVID 19” OR “coronavirus” AND “brain” OR “CNS” OR “neurologic”.

Results

      Through the search strategy, we could identify two articles about neurological involvement by COVID-19. One of these publications was a narrative review and the other one was a viewpoint. However, the authors scanned the reference lists of the included studies and could identify multiple references. One study, specifically investigated the neurological manifestations of COVID-19 and could document CNS manifestations in 25% of the patients. Most of the studies investigated the manifestations of COVID-19 in general.

Conclusions

      While neurological manifestations of COVID-19 have not been studied appropriately, it is highly likely that some of these patients, particularly those who suffer from a severe illness, have CNS involvement and neurological manifestations. Precise and targeted documentation of neurological symptoms, detailed clinical, neurological, and electrophysiological investigations of the patients, attempts to isolate SARS-CoV-2 from cerebrospinal fluid, and autopsies of the COVID-19 victims may clarify the role played by this virus in causing neurological manifestations.

Keywords: CNS, Coronavirus, COVID-19, Neurological, Seizure.