[Prospects and possibilities for the treatment of patients with long COVID-19 syndrome].

AIM: To study the efficacy and safety of a drug product based on the succinic acid complex with trimethylhydrazine used to treat patients with asthenic syndrome after a new coronavirus infection (COVID-19). MATERIALS AND METHODS: A prospective, multicenter, comparative, randomized, double-blind, placebo-controlled study of the safety and efficacy of sequential therapy with Brainmax® enrolled 160 patients 12-16 weeks after coronavirus infection (no more than 12 months). The study was conducted at 6 healthcare centers in different regions of the Russian Federation. At the enrollment, clinical and neurological examination and the following tests were performed: complete blood count, urinalysis, blood chemistry, coagulation test, pulse oximetry, electrocardiography, glomerular filtration rate calculation (according to Cockcroft-Gault formula) were performed. Also, the patients were assessed using the following tools: VAS headache rating scale, MFI-20 asthenia scale, PSQI index, FAS-10 fatigue assessment scale, Dizziness Handicap Inventory (DHI), MoCA-test for cognitive impairment assessment, Beck Anxiety Inventory, Kérdö Autonomic Index. RESULTS: The primary endpoint was the mean reduction in the MFI-20 asthenia scale score after the therapy (Visit 5, 41st day of therapy) compared to data from Visit 0 (beginning of therapy). A clinically significant advantage of the study drug versus the placebo was demonstrated, with a median absolute change in the MFI-20 score of -19.5 [-27; -11] points in the Brainmax® drug group and -3 [-7; 1] score in the placebo group (p<0.001). A significant sleep quality improvement according to the PSQI index was shown in the study group: by -2.5 [-4; -1] points versus no improvement in the placebo group (0 [-3; 0], p<0,001). Significant differences were also noted for the following secondary endpoints: PSQI sleep quality scale, FAS-10 fatigue assessment scale, DHI, and Beck Anxiety and Depression Inventory. There was also a decrease in patients' complaints of cognitive deterioration according to the CGI scale. CONCLUSION: Our study clearly demonstrated the efficacy and high safety profile of Brainmax® in a representative sample of patients with the post-COVID syndrome.

[Asthenic post-COVID syndrome]. / Astenicheskii postkovidnyi sindrom.

OBJECTIVE: To evaluate the efficacy and safety of combination therapy for post-COVID asthenic syndrome with multicomponent bioregulatory drugs Traumeel S, Ubichinon compositum and Coenzyme compositum. MATERIAL AND METHODS: The study included 104 patients (averaged age 39.5 [30.8; 48] years) after COVID-19, clinically recovered from an acute infectious process, with asthenic syndrome lasting from 2 weeks to 6 months; the severity of asthenic syndrome on the asthenia VAS scale was at least 30 points. Before the start of the study, in addition to a physical examination, the patient's condition was assessed using the following questionnaires and scales: VAS for asthenia, subjective scale for assessing asthenia (MFI-20), L.D. Malkova, a questionnaire for the quality of life (EQ-5D), a questionnaire for identifying signs of autonomic disorders (Vayne A.M.). The patient's condition was monitored during follow-up visits 2 weeks, 1 month after the start of treatment and 1 month after the end of treatment. Patients of the main group received combination therapy, which included Traumeel S 1 tablet x 3 times a day, Ubichinone compositum and Coenzyme compositum 2.2 ml intramuscularly, alternating every other day, for 1 month (15 injections of each drug per course of treatment). Patients of the comparison group received eleutherococcus extract 100 mg during 30 days, 2 tablets x 2 times a day before mealsand vitamins B. The effectiveness of therapy was assessed by analysis of the asthenia severity (VAS scale), quality of life (EQ-5D questionnaire), patient satisfaction with treatment on a 5-point scale, which was carried out 1 month after the end of the course of treatment. RESULTS: As a result of the treatment was positive. The general asthenia severity, low activity and motivation significantly decreased in patients of both groups without significant differences. At the same time, in patients of the comparison group, there was no correlation between the quality of life and physical and mental asthenia, while in the main group there was an inverse correlation with the asthenia severity, which indicates an increase in the quality of life with a decrease in the severity of asthenia. One of the significant differences was the regression of headache and musculoskeletal pain in patients of the main group. CONCLUSION: The advantage of combined therapy of post-COVID asthenic syndrome with bioregulation therapy Traumeel S, Ubichinone compositum and Coenzyme compositum was shown in comparison with one of the common treatment regimens, including eleutherococcus extract and combined preparations of B vitamins.

Astenic syndrome in you students with different online-behaviors during the pandemic of new coronavirus infection COVID-19

Introduction. An urgent problem in many countries of the world is the growth of comorbid diseases and conditions associated with the pathological use of the Internet, including functional somatic disorders, which include asthenic syndrome. Purpose of the study. To study the frequency of occurrence of asthenic syndrome schoolchildren with different online behavior during the coronavirus pandemic. Materials and methods. The method of random sampling was used to examine 1 148 adolescents at the age of 11–18 years, of which 535 (46.6%) were boys and 613 (53.4%) were girls. The frequency of occurrence was analyzed in the entire sample of the surveyed, as well as in the comparison groups, formed by gender: 1 gr. – boys (n = 535), 2 gr. – girls (n = 613), age: 1 gr. – 11–14 years old (m + d) (n = 837) and 2 gr. – 15–18 years old (m + d) (n = 311), type of online behavior: 1 gr. – with adaptive use of the Internet, 2 gr. – with maladaptive internet use, 3 gr. – with pathological use of the Internet and type of Internet addiction. Results. The frequency of adaptive use of the Internet was 37.0%, with maladaptive – 49.9% and with pathological – 13.1% of the total sample of the surveyed. The content structure of the online behavior of Tuvan schoolchildren includes the presence of a game Internet addiction in 4.4% of the surveyed, dependence on social networks – in 12.5%, mixed IА – in 2.4% and undifferentiated IА – in 5.0%. The frequency of asthenic syndrome is 12.2% of all surveyed. Conclusion. A more pronounced association of asthenic syndrome in schoolchildren with maladaptive online behavior indicates the negative impact of the computer and the Internet on the body and justifies the need for a personalized approach to these contingents. © 2022, Remedium Group Ltd. All rights reserved.

[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.

[COVID-19 effect on mental health and sleep disorders]. / Psikhoemotsional'nye rasstroistva i narusheniya sna u patsientov s COVID-19.

PURPOSE OF THE STUDY: To study the prevalence of anxiety-depressive disorders and sleep disorders in their structure among patients hospitalized in connection with COVID-19, as well as to develop differentiated recommendations for their therapy in patients with new coronavirus infection. MATERIAL AND METHODS: In this publication, the authors present preliminary results of their own observations of psychoemotional disorders and sleep disorders in their structure in patients with a new coronavirus infection. We analyzed the data of 119 patients (aged 47 to 69 years, male and female), conducted a detailed interview, including using telemedicine technologies, and assessed the scales: The hospital Anxiety and Depression Scale (HADS), subjective the asthenia rating scale (MFI-20, Multidimensional Fatigue Inventory) and the Pittsburgh Sleep Quality Index (PSQI) questionnaire. RESULTS: According to the results of the HADS questionnaire, clinically pronounced anxiety-depressive symptoms were observed in 33 (28%) patients of 119 hospitalized in connection with the diagnosis of COVID-19. Of them, only clinically significant anxiety was recorded in 11% of cases (n=13), in 5 (4%) patients - clinically significant depression, an increase in both subscales of anxiety and depression - in 13% (n=15). An increase in the MFI-20 scale (more than 20 points) was found in 87 (73%) patients, sleep disorders in accordance with the PSQI questionnaire was recorded in 32 (27%) patients. CONCLUSION: According to the results of the study, it was noted that in most patients with COVID-19, along with a depressive symptom complex, anxiety and hypochondriacal disorders, an asthenic symptom complex, sleep disturbances with difficulty falling asleep, and dissatisfaction with the quality of sleep are recorded. Differentiated recommendations for the treatment of the studied conditions have been developed, taking into account the side effects of the prescribed drugs, drug interactions and the characteristics of the somatic status of patients. The choice of the drug should be based on the severity of the violations identified.

[Post-COVID-19 asthenic syndrome]. / Astenicheskii sindrom u patsientov, perenesshikh COVID-19.

OBJECTIVE: To study the features of asthenic syndrome and the possibilities of its therapy in patients in the post-covid period. MATERIAL AND METHODS: The study included 129 patients with an average age of 49.8±8.9 years who had undergone COVID-19 using a continuous sample method. Patients for the study were selected at the clinical bases of outpatient clinics in Samara (Russia) in July-August 2020. All patients signed an informed consent form prior to enrollment. Patients were randomized into two groups: in the main group (n=64), ethylmethylhydroxypyridine succinate (Neurox) was prescribed 1 tablet (125 mg) 3 times a day for 4 weeks; in the comparison group (n=65), medical drugs (MD) did not contain substances from the pharmacological group related to antihypoxants/antioxidants/nootropics. Three visits (V) were conducted: the first (V1) - the period of inclusion, the second (V2) - after 14 days, the third (V3) - on the 28th day from the start of therapy. The dynamics of the general state (weakness, fatigue, concentration, dizziness, headache, sleep disorders) were evaluated on a visual-analog scale (VAS), the assessment of the subjective feeling of severity of asthenia (fatigue, physical and mental fatigue, decreased motivation and activity) - on Multidimensional Fatigue Inventory (MFI-20), cognitive functions - on Mini-Mental State Examination (MMSE), vegetative tone - according to the Kerdo index. RESULTS: At the end of the study (V3), statistically significant changes in indicators (VAS, MFI-20) were obtained only in the main group patients; no statistically significant differences were obtained for the Kerdo index. Analysis of the MMSE data revealed a decrease in cognitive functions in both groups, which may be associated with pseudocognitive deficits due to asthenia. CONCLUSIONS: We have obtained evidence of a high incidence of asthenic syndrome after COVID-19. Against the background of taking Neurox, there was a decrease in the severity and expression of asthenia symptoms.