[Current approaches in the treatment and rehabilitation of patients with neurological diseases after COVID-19. Resolution of the International Experts Forum]. / Lechenie i reabilitatsiya bol'nykh s nevrologicheskimi narusheniyami posle perenesennogo COVID-19. Rezolyutsiya Mezhdunarodnogo foruma ekspertov.

Despite the significant shift in global attention away from the pandemic, the problem of a new coronavirus infection remains important in the medical community. Almost 3 years after the start of the COVID-19 pandemic the issues of rehabilitation and management of delayed manifestations and sequelae of the disease are especially important. According to numerous available data, the new coronavirus infection is characterized by multiorgan lesions. Respiratory dysfunction, clotting disorders, myocardial dysfunction and various arrhythmias, acute coronary syndrome, acute renal failure, GI disorders, hepatocellular damage, hyperglycemia and ketosis, dermatological complications, ophthalmological symptoms and neurological disorders may be found. Significant prevalence of the latter in the post-coronavirus period necessitated this International Expert Forum to develop unified approaches to the management of patients with neurological complications and sequelae of new coronavirus infection based on practical experience and considering the scientific information available on COVID-19. The expert council developed a resolution formulating the tactics for the management of patients with neurological manifestations of COVID-19.

Neurological Complications of COVID-19 in the Elderly.

SARS-CoV-2 virus is a ß-coronavirus and produces a severe viral pneumonia which can be complicated by acute respiratory distress syndrome and multiorgan failure. As knowledge of the new coronavirus infection (COVID-19) increases, it has become known that SARS-CoV-2 has pronounced neurotropism, producing a wide spectrum of neurological complications. This article addresses the characteristics of the neurological complications of COVID-19 in elderly people.

Pathomorphological changes in some organs and tissues of COVID-19 convalescent patients

New coronavirus infection (COVID-19) is highly contagious viral disease caused by SARS-CoV-2 leading to the pandemic. The autopsy of COVID-19 patients often showed features of previous brain diseases including neurodegeneration, previous strokes, demyelinating diseases and atherosclerosis. Patients with acute cerebrovascular accidents and severe COVID-19 had higher numbers of lethality in comparison to non-severe course of infection without cerebrovascular accidents. A comparative analysis of morphological changes in lungs of deceased patients who died in different periods of first clinical symptoms is to be conducted. Objective. Description of pathomorphological changes in deceased patients during the period of reconvalescence. Patients and methods. The analysis of 15 fatal cases which took place in Botkin Hospital with the diagnosis of ischemic stroke and new coronavirus infection in the previous 2-4 months has been held. Macro and microscope examination of brain, lungs, brachiocephalic arteries, kidneys and liver has been carried out. Results. All patients had morphological features of ischemic damage of grey matter in the brain. Beside necrosis of neurocytes with diffuse infiltration in the grey matter, hematoxylin cycles were found, in some cases they were placed in a perivascular way in choroid plexus. Also 5 patients suffered a myocardial infarction up to 3 days. 10 patients had structures disorganisation in areas of lung parenchyma with hystoacrchitectonic changes because of the fibrosis. Alveoli in some places collaborated mostly with single airway clearance. The fact that most patients had lung hemosiderosis can prove coronavirus infection suffered earlier with microcirculatory bed damage. Conclusion. Thus, morphological changes seen in the period of reconvalescence of COVID-19 is a result of pathomorphosis of changes described earlier for acute period of coronavirus infection and affect not only lungs, but also other organs and tissues. This proves systematic characteristic of the infection.

Neurological Complications of COVID-19 in the Elderly

SARS-CoV-2 virus is a β-coronavirus and produces a severe viral pneumonia which can be complicated by acute respiratory distress syndrome and multiorgan failure. As knowledge of the new coronavirus infection (COVID-19) increases, it has become known that SARS-CoV-2 has pronounced neurotropism, producing a wide spectrum of neurological complications. This article addresses the characteristics of the neurological complications of COVID-19 in elderly people.

[Chronic fatigue syndrome against the background of the COVID-19 pandemic]. / Sindrom khronicheskoi ustalosti na fone pandemii COVID-19.

The more we learn about the new coronavirus infection, the more we understand that we will feel the echoes of the pandemic for many years, and those who have successfully endured the acute phase of COVID-19 may face the consequences of the infection. One of the most frequent manifestations will be the development of chronic fatigue syndrome (CFS) after COVID-19. This article discusses the possible causes of the development of CFS, as well as possible ways of its treatment and prevention.

[Neurological complications of COVID-19 in elderly people]. / Nevrologicheskie proyavleniya COVID-19 u pozhilykh.

Virus SARS-CoV2 (beta-coronavirus) can induce severe pneumonia with acute respiratory distress syndrome, respiratory failure and multiorgan dysfunction. As more we learned about Covid-19, we understand that SARS-CoV-2 have neuroinvasive properties and can cause different neurological complications. In this article we discusses about the features of neurological sequences of Covid-19 in elderly people.

[Current issues of treatment and rehabilitation of patients with neurological disorders and the consequences of COVID-19. Resolution of Advisory Board]. / Osnovnye napravleniya lecheniya i reabilitatsii nevrologicheskikh proyavlenii COVID-19. Rezolyutsiya soveta ekspertov.

Last year the global medical community faced the pandemic of the new coronavirus infection caused by SARS-CoV-2. To date, there is considerable expert experience, which indicates that the brain, along with the corresponding respiratory system, is a target organ for a new coronavirus infection. Moreover, a number of symptoms from the central and peripheral nervous system can persist for several weeks, months, and even tens of months. To designate such protracted clinical conditions, a new definition was introduced: «Post-COVID-19 Condition¼. Advisory Board of Neurologists and Rehabilitation Therapists met to, discuss of practical experience and taking into account scientific information about COVID-19, which was available at the time of the meeting, to develop unified approaches for the management of patients with neurological complications and the consequences of a new coronavirus infection. The Advisory Board worked out a resolution in which formulated the tactics of managing patients with neurological manifestations of COVID-19. The substantiation of the importance and expediency of the development and implementation of a special program of clinical examination of patients who have undergone COVID-19, which would include a clinical examination with a detailed assessment of cognitive functions to early identification and diagnosis of neurodegeneration and subsequent therapy, is given.

[Poststroke motor and cognitive impairments: clinical features and current approaches to rehabilitation]. / Postinsul'tnye dvigatel'nye i kognitivnye narusheniya: klinicheskie osobennosti i sovremennye podkhody k reabilitatsii.

Stroke is one of the most common neurological diseases with high morbidity, disability and mortality, which is an urgent medical and social problem. Clinically, stroke, depending on its nature and location, causes a wide range of neurological disorders, including movement disorders, as well as a variety of cognitive and neuropsychiatric disorders. There is an emerging need for new approaches to manage patients with cerebrovascular diseases during the pandemic of COVID-19. Rehabilitation measures for the correction of motor and cognitive impairments are very diverse. The use of drugs stimulating the production of neurotrophic factors is considered as a promising direction of pharmacotherapy. Cerebrolysin promotes significant regression of motor and cognitive impairments in the acute and recovery period of ischemic stroke. Based on the data of clinical studies, Cerebrolysin is included in the guidelines for the rehabilitation of patients with stroke in Canada and Germany.

[Current issues in the rehabilitation of stroke patients against the background of a new coronavirus infection (COVID-19). Resolution of the Council of Experts]. / Aktual'nye voprosy reabilitatsii patsientov s insul'tom na fone novoi koronavirusnoi infektsii (COVID-19). Rezolyutsiya Soveta ekspertov.

The pandemic of the new coronavirus infection caused by SARS-CoV-2 has forced to reconsider the methods of rehabilitation of patients with emergency conditions, including neurology. The Council of Experts of Neurologists and Rehabilitation Therapists gathered to develop unified approaches to manage stroke patients based on a discussion of practical experience and, taking into account the scientific information on COVID-19 that was available by the time of the meeting. Stroke is a serious disabling condition that requires maximum rehabilitation efforts at all stages of medical care. In the context of the SARS-CoV-2 coronavirus epidemic, the process of medical rehabilitation and the routing of patients with stroke is undergoing major changes. Combining COVID-19 and stroke requires new approaches to rehabilitation and patient management. During the meeting, a resolution was developed in which the experts formulated the tactics of medical rehabilitation of patients with stroke and COVID-19 at the first and second stages. The arguments of the importance and practicability of carrying out measures of medical rehabilitation at the third stage is given and the need to continue consultations on the indicated topic is revealed.