Determination of the prevalence of postcovid syndrome and assessment of the effectiveness of the drug Cortexin in the treatment of neurological disorders in patients with postcovid syndrome. Results of the multicenter clinical and epidemiological observational program CORTEX

Neurological Aspects of the Sequelae of COVID-19 in Children

“…A recent extensive observational program that included the analysis of complaints of 979 patients aged 18-80 (mean 54.6 ± 14.5 years) who experienced COVID-19 (disease duration from 1 month to 1 year overall and 1-6 months in 78% of patients) showed that the most common complaints (more than 80% of patients) were general weakness, fatigue, decreased concentration, forgetfulness, anxiety, and sleep disturbances. Also frequent (50-79%) were complaints of impaired sense of smell, dizziness, and irritability, and, somewhat less frequently (in 31.6%) -tinnitus, feelings of fear, tearfulness, excessive sweating, paresthesia, blurred vision, pain, blood pressure instability, shortness of breath, palpitations, hair loss, and allergic reactions; there was no signifi cant relationship between clinical symptoms and the severity of COVID-19, the volume of lung tissue damage, or different time points after the acute phase [18].…”

“…Use of Cortexin in asthenic post-covid disorders helped reduce fatigue (more than three-fold) and general weakness (more than four-fold) and normalize sleep, while both doses (10 and 20 mg) were effective in relieving asthenia, though patients receiving Cortexin 20 mg showed more marked dynamics. Use of Cortexin in post-COVID cognitive disorders contributed to a decrease in manifestations of forgetfulness and an increase in concentration of attention by factors of greater than three, while both doses (10 and 20 mg) showed comparable effi cacy in the treatment of cognitive impairment [18]. In patients with post-COVID emotional disorders, use of Cortexin contributed to a four-fold decrease in irritability and anxiety and reductions in tearfulness, aggressiveness, and fear in almost all patients, while Cortexin 20 mg produced more marked anti-anxiety, antidepressant, and anxiolytic effects.…”

“…Cortexin has been shown to be highly effective in treating the neurological sequelae of coronavirus infection, which is based on its complex actions, maintaining the integrity of the BBB through interaction with cytoskeletal proteins (actin, 14-3-3-α/β), which are functionally associated with tight junction proteins in endothelial cells; it has positive effects on energy metabolism, providing neuroprotection in hypoxia, interacting with CPK-BB (it takes part in energy metabolism, maintaining constant ATP and creatine phosphate levels in cells; it modulates ATP content in hypoxia); it regulates the division, proliferation, migration, and differentiation of neurons due to interaction with cytoskeletal proteins that modulate neurogenesis; it takes part in the formation of synaptic plasticity due to interaction with the adapter protein 14-3-3α/β (which regulates the operation of glutamate receptors, as well as the dynamics of actin); it optimizes excitatory/inhibitory processes and synaptic plasticity, prevents excitotoxicity, and has effects on ionotropic and metabotropic glutamate and GABA receptors [18,[47][48][49]53].…”

“…syndrome and moderate cognitive impairment, which were assessed using the MFI-20, MMSE, and Schulte test [18]. Cortexin 10 mg was used in 59.6% of patients, the remainder receiving a dose of 20 mg; course duration was 10 days.…”

“…Thus, this multicenter clinical and epidemiological follow-up program confi rmed the effi cacy of Cortexin in correcting asthenic and cognitive symptoms in patients with post-covid syndrome and demonstrated dose-dependent effects of Cortexin on asthenic and anxious-depressive disorders. The high effi ciency of Cortexin in correcting cognitive impairment and asthenia, the presence of an anxiolytic effect, the absence of side effects, and compatibility with other drugs provide grounds for considering the use of Cortexin in the treatment of patients with post-COVID syndrome [18]. When planning the correction of PCS in children, it is also important to organize a regime of teaching and resting (a sparing schedule with limited schoolwork is required), lengthening of daytime and nighttime sleep, with suffi cient time spent in the air, and avoidance of intense physical activities while maintaining therapeutic exercise (at school in a special group program or at home following exercise therapy plans, usually aimed at developing coordination), as well as good nutrition (inclusion of foods rich in tryptophan and groups B and C vitamins in the diet).…”