Introduction. Asthenic disorders due to COVID-19 infection are generally classified under a recently introduced category in ICD-10: U09.9 Condition after COVID-19, unspecified. In this regard, it is necessary to study the clinical manifestations and systematize the asthenic syndrome after coronavirus infection in order to better understand the tactics of treatment and rehabilitation of this group of patients.Objective. To assess the prevalence of asthenic syndrome in patients who have had a coronavirus infection, to characterize and present its dynamics.Materials and methods. The study involved 200 people with a confirmed diagnosis of COVID-19, aged 51 to 83, who were undergoing inpatient treatment. After discharge from the hospital after 6 months and 12 months, these patients again underwent a physical examination, anamnesis, complaints, and a questionnaire to identify symptoms of asthenia and other psychopathological syndromes.Results. Asthenic symptoms were found in 2/3 of the examined persons. Autonomic disorders were noted with a slight decrease from 81.5% after 6 months to 74.2% after 12. Sleep disorders and increased fatigue progressed during the observed period from 70.4% to 80.6% and 63.0 to 74.2% respectively. Emotional lability of patients as a whole did not change.Conclusion. Polymorphic symptoms of asthenic syndrome were revealed, the most common phenomena were sleep disorders and symptoms of fatigue.
Стойкие когнитивные нарушения наблюдаются у значительного числа пациентов после перенесенной коронавирусной инфекции (COVID-19). Необходимы исследования, чтобы изучить структуру когнитивных изменений, динамику их появления и длительность сохранения. Целью нашего исследования было охарактеризовать динамику и структуру когнитивных нарушений у пациентов, перенесших коронавирусную инфекцию средней степени тяжести, через 6 и 12 месяцев после выписки из стационара. В исследовании приняли участие 200 пациентов с подтвержденным диагнозом «новая коронавирусная инфекция COVID-19 средней степени тяжести, осложненная дыхательной недостаточностью на фоне двусторонней полисегментарной вирусной пневмонии, вызванной SARS-CoV-2», в возрасте от 24 до 92 лет. Пациенты были разделены на две возрастные группы до и после 65 лет, каждая группа делилась на подгруппы соответственно полу. Когнитивное обследование проводилось дважды – через 6 и 12 месяцев после выписки из стационара. Когнитивные функции оценивали с помощью модифицированной Адденбругской когнитивной шкалы и батареи тестов для оценки лобной дисфункции. Все участники исследования имели нарушения хотя бы в одном когнитивном домене вне зависимости от возраста и пола. Наиболее уязвимыми когнитивными функциями после коронавирусной инфекции оказались антероградный и ретроградный компоненты памяти и речевая активность. Число баллов по данному домену находилось в диапазоне значений от 22,6 ± 2,5 до 17,6 ± 4,3 балла. При этом у обследуемых отмечалась отчетливая тенденция к постепенному снижению данной функции к 12-му месяцу после выписки из стационара. Речевая активность была существенно снижена во всех возрастных группах – у пациентов из первой группы в динамике средний балл составлял 11,2 ± 0,8 через 6 месяцев и 9,9 ± 1,0 балла через 12 месяцев, а во второй группе – 8,4 ± 2,1 и 8,7 ± 2,2 балла соответственно. Установлено, что в отдаленном периоде после перенесенной коронавирусной инфекции возникают серьезные когнитивнные нарушения как у молодых пациентов, так и у людей старшего возраста. Persistent cognitive impairment is observed in a significant number of patients after coronavirus infection (COVID-19). Research is needed to study the structure of cognitive changes, the dynamics of their occurrence and the duration of their persistence. The purpose was to study the dynamics and structure of cognitive impairment in patients who had a moderate coronavirus infection within 12 months after discharge from the hospital. The study involved 200 patients with a confirmed diagnosis of a moderately severe novel coronavirus infection COVID-19, complicated by respiratory failure against the background of bilateral polysegmental viral pneumonia caused by SARS-CoV-2, aged 24 to 92 years. All patients were divided into two main groups by age: the first – persons under 65 years of age, the second – persons over 65 years of age, each group was divided into a subgroup by gender. Conducting a cognitive examination was carried out twice – 6 and 12 months after discharge from the hospital. Cognitive function was assessed using the modified Addenbrugs Cognitive Scale and frontal dysfunction test battery. All study participants had impairments in at least one cognitive domain, regardless of age and gender. The most vulnerable cognitive functions during coronavirus infection were the anterograde and retrograde components of memory and speech activity. The number of points for this domain ranged from 22,6 ± 2,5 to 17,6 ± 4,3. At the same time, the subjects showed a clear trend towards a gradual decrease in this function by 12 months after discharge from the hospital. Speech activity was significantly reduced in all age groups – in patients from the first group in dynamics, the average score was 11,2 ± 0,8 after 6 months and 9,9 ± 1,0 after 12 months, and in the second group 8,4 ± 2,1 points and 8,7 ± 2,2 points, respectively. Our study showed that after a coronavirus infection in the long term, serious cognitive impairments occur in both young and older patients.
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