Клинический разбор в общей медицине (Jan 2021)

Fatigue and cognitive impairment in post-COVID-19 patients. Actovegin potential in their management

  • Tatiana M. Ostroumova,
  • Olga D. Ostroumova,
  • Elizaveta Yu. Ebzeeva ,
  • Nikita A. Arablinskiy

DOI
https://doi.org/10.47407/kr2021.2.1.00035
Journal volume & issue
Vol. 2, no. 1
pp. 28 – 34

Abstract

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A definite well-established term that would describe the full range of symptoms that patients who have had COVID-19 complain about does not exist. The terms “Post-COVID-19 syndrome”, “Long-COVID-19”, “Post-acute COVID-19” and “long-term effects of COVID-19” have been proposed. In the absence of clear diagnostic criteria, the potential consequences of the COVID-19 can be considered as symptoms that persist for 2–3 weeks or longer after the development of the first symptoms of COVID-19. Fatigue and cognitive impairment (CI) are one of the most common symptoms in patients with COVID-19. Fatigue is one of the most common symptoms among COVID-19 patients, which can persist for more than 100 days after the onset of respiratory symptoms. The risk factors for fatigue and CI in patients with COVID-19 have not been definitively established and continue to be studied. The pathogenesis of the development of asthenia and CI at the moment are currently in research, however, it is obvious that the pathophysiology is multifactorial. The ability of SARS-CoV-2 to damage nerve cells requires clarification. At the same time, it is obvious that an important role in the development of post-COVID-19 fatigue and CI is played by the endothelial dysfunction and microcirculation disorders, which, in turn, develop as a result of systemic inflammation and coagulopathy present in this infection. Approaches to the prevention and treatment of post-COVID-19 fatigue and CI are also currently in research. There are single papers that present the effectiveness of antiviral drugs; there is also no doubt about the need to correct the comorbid vascular risk factors of fatigue and CI. There is also evidence of an improvement in the condition of post-COVID-19 patients who recieved Actovegin therapy. A case series of patients who consulted a neurologist, who, due to persisting complaints of fatigue and CI, were prescribed Actovegin 600 mg/day was published. Within 1–3 months, all patients noted a decrease in the severity of cognitive and fatigue symptoms.

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