Neurological Aspects of the Sequelae of COVID-19 in Children.

It has now been established that neurological and neuropsychiatric disorders persist for prolonged periods in a significant proportion of adult patients who have had COVID-19, though there is much less information about the manifestations of post-COVID syndrome (PCS) in children and adolescents. This review presents data on the features of the course of PCS in young patients, and considers the options for treating these patients. The results of studies on the use of Cortexin for correcting cognitive and emotional disorders are analyzed.

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 CORTEX Multicenter Clinical and Epidemiological Observational Program.

Objectives. To study the prevalence and clinical manifestations of postcovid syndrome (PCS) in out-patients and to assess the efficacy of treatment with the drug Cortexin at doses of 10 and 20 mg i.m. for 10 days. Materials and methods. A total of 979 patients with PCS from regions of the Russian Federation, Azerbaijan, Kyrgyzstan, and Kazakhstan were studied; mean age was 54.6 ± 4.5 years; duration of COVID-19 was from one month upwards. Investigations involved three visits. The first was on the day of consultation (assessment of complaints, analysis of scale indicators, prescription of drug Cortexin at a dose of 10 or 20 mg i.m. for 10 days). The second visit (telephone consultation) was on day 10-14. The third visit was on day 30 of out-patient treatment. Assessment of patients' status used an asthenia assessment scale (MFI-20), a brief mental state assessment scale (MMSE), the Schulte test, and the Subjective Treatment Quality Assessment Scale. Results. The proportion of patients with PCS was up to 30% of all neurological admissions. The commonest manifestations were: fatigue, general weakness, decreased memory and concentration of attention, vertigo, sleep impairment, irritability, and aggression; less frequent were breathlessness, pain, increased sweating, anosmia, hyposmia, dysgeusia, paresthesia, hair loss, degradation of vision, tachycardia, allergic reactions, menstrual cycle impairments, erectile dysfunction, panic attacks, suicidal ideation, depression and refusal to eat meat. Conclusions: No associations were found between clinical symptomatology and the severity of COVID-19, the volume of lung tissue affected, or different periods of postcovid syndrome. Cortexin was found to be effective at doses of 10 and 20 mg for correcting the cognitive and asthenic manifestations of PCS. Cortexin was found to have anti-anxiety, antidepressant, and anxiolytic effects, which were more marked at the 20-mg dose.

[Neurological disorders in the postcovid period]. / Nevrologicheskie narusheniya v postkovidnom periode.

The consequences of COVID-19 include a wide range of neurological, emotional and cognitive impairments. The pathogenesis of postcovid disorders is complex and has not been fully studied. The article discusses the pathogenesis and clinical manifestations of neuropostocoid. A hypothesis is formulated about the possible role of circumventricular organs in its formation. The main directions of treatment of patients with postcovid disorders are proposed.

[Neurological aspects of the consequences of COVID-19 in children]. / Nevrologicheskie aspekty posledstvii COVID-19 u detei.

To date, it is well established that neurological and neuropsychic disorders persist for a long time in a significant part of adult patients who have undergone COVID-19, despite the fact that there is much less information about the manifestations of postcovid syndrome (PCS) in children and adolescents. The review provides data on the features of the course of PCS in young patients, discusses the possibilities of treating such patients. The results of studies on the use of the drug Cortexin for the correction of cognitive and emotional disorders are analyzed.

[The use of neurotropic therapy in young patients with postcovid syndrome]. / Primenenie neirotropnoi terapii u molodykh patsientov s postkovidnym sindromom.

OBJECTIVE: The aim of the present study was to identify postcovid asthenic syndrome and cognitive disorders in young patients on an outpatient basis, and to evaluate the experience of using combined neurotropic therapy in this category of patients. MATERIAL AND METHODS: Included 87 young patients who underwent COVID-19 and applied for an outpatient appointment with a neurologist. All patients underwent a scale assessment of the severity of asthenia on the MFI-20 scale, cognitive functions - on the MMSE scale, the 5-word test and the Schulte test. The severity of the anxiety syndrome - according to the Spielberger Anxiety Scale. All patients in the study group were treated with a combination of Cortexin and Recognan, and a repeat study was conducted 4 weeks after treatment. RESULTS: The study revealed the predominance in the observation group of patients with a comorbid background, as well as pronounced anxiety disorders. After the complex treatment, there was a significant decrease in the indicators of common, physical, mental asthenia, as well as an increase in motivational activity, there was a decrease in situational anxiety, and to a lesser extent personal anxiety. According to cognitive tests, there was an improvement in indicators on the MMSE scale, direct reproduction of the 5-word test, significant changes in the evaluation of work efficiency when performing the Schulte test. CONCLUSION: It should be noted that the positive results of this study can be considered a decrease in the severity and severity of asthenia symptoms, a decrease in anxiety manifestations, and an improvement in cognitive functions against the background of complex neurotropic therapy with Cortexin and Recognan. Preference in this situation should be given to drugs with a multimodal mechanism of action, as well as creating optimal combinations of drugs that potentiate each other's action.

[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]. / Opredelenie rasprostranennosti postkovidnogo sindroma i otsenka effektivnosti preparata Korteksin v terapii nevrologicheskikh narushenii u patsientov s postkovidnym sindromom. Rezul'taty mnogotsentrovoi nablyudatel'noi programmy KORTEKS.

OBJECTIVE: To study the prevalence of clinical manifestations of postcoid syndrome in patients at an outpatient neurological appointment, to evaluate the effectiveness of therapy regimens using Cortexin at doses of 10 mg and 20 mg IM for 10 days. MATERIALS AND METHODS: 674 neurologists from all regions of the Russian Federation, Azerbaijan, Kyrgyzstan and Kazakhstan took part in the study. A total of 979 COVID-19 patients were recruited. The average age is 54.6±0.45 years. The duration of the transferred SARS-CoV-2 days and from 1 month or more 12. 3 visits were carried out: 1 on the day of treatment (assessment of complaints, analysis of scale indicators, prescription of the drug Cortexin in doses of 10-20 mg/m for 10 days). 2 (telephone survey) visit for 10-14 days, 3 visit - for 30 days at the reception. The condition was assessed using the Asthenia Assessment Scale (MFI-20), the Brief Mental Status Assessment Scale (MMSE questionnaire), the Schulte test, and the Subjective Treatment Quality Assessment Scale. RESULTS: The daily proportion of patients with complaints after a previous coronavirus infection was 30% in the total structure of neurological admission. The most common complaints: fatigue, general weakness, decreased memory and concentration, dizziness, sleep disturbance, irritability, aggression, shortness of breath, pain syndromes, excessive sweating, anosmia, hyposmia, perverted taste of paresthesia, hair loss, blurred vision, unstable blood pressure, tachycardia, allergic reactions, menstrual irregularities, erectile dysfunction, apathy, panic attacks, suicidal thoughts, depression, refusal to eat meat. CONCLUSION: There was no significant correlation of clinical symptoms with the severity of COVID-19, the percentage of lung tissue damage, and different periods of postcovid syndrome. The clinical efficacy of the drug Cortexin in dosages of 10 and 20 mg for the correction of cognitive and asthenic disorders has been proven. Revealed anti-anxiety, antidepressant and anxiolytic activity of Cortexin is more pronounced when using a dosage of 20 mg.

[Asthenic disorders as a manifestation of chronic fatigue syndrome]. / Astenicheskie rasstroistva kak proyavlenie sindroma khronicheskoi ustalosti.

The article explains the changes in terminology and diagnostic criteria for asthenic disorders as manifestations of chronic fatigue syndrome CFS (myalgic encephalomyelitis). Chronic fatigue syndrome is defined as neuroimmune endocrine dysfunction with a purely clinical diagnosis. Probably, viral infections can play a leading role in the pathogenesis. Published diagnostic criteria reveal possible correlations between chronic fatigue syndrome and COVID-19 disease. A promising strategy for the therapy and rehabilitation of patients is the use of smart peptides, a representative of which is the drug cortexin.