Mediating role of psychological resilience in relationship between stress and anxiety symptoms of medical students in post COVID-19 period

[Background] In the post-pandemic period, attention has been paid to the study of psychological stage changes in various groups. Under the stress of pandemics, how to control negative emotions such as anxiety symptoms will have an important impact on medical students' professional identity and future professional competence. [Objective] This study is designed to explore the characteristics of stress and anxiety symptoms of medical students in different stages of the post COVID-19 period, and potential mediating role of psychological resilience in the relationship between stress and anxiety symptoms. [Methods] By convenience sampling method, 3 000 medical students from three medical colleges in Shaanxi Province were selected and completed an online survey reporting the Self-Rating Anxiety Scale (SAS), Stress Scale for College Student (SSCS), and Resilience Scale of Adults (RSA) to assess their stress, psychological resilience, and anxiety symptoms in September and November 2020. SPSS 25.0 software was used to perform dependent-sample t test, variance analysis, Pearson correlation analysis, and mediating effect test (hierarchical regression analysis). [Results] A total of 2 894 valid questionnaires were recovered and the valid recovery rate was 96.5%. The overall scores of stress, psychological resilience, and anxiety symptoms of selected medical students were 56.61+/-17.17, 166.88+/-28.55, and 40.45+/-9.67, respectively in the post COVID-19 period. The positive rate of high stress was 72.2%, and the positive rate of anxiety symptoms was 16.0%. There were significant differences in anxiety symptoms scores between the high and the low stress level groups (42.16+/-9.92, 35.99+/-7.30) (P < 0.01). There were significant differences in scores of stress, psychological resilience, and anxiety symptoms among different grade groups (P < 0.01). The pearson correlation analysis results showed that the stress score was positively correlated with the anxiety symptom score (r=0.417, P < 0.01) and negatively correlated with the psychological resilience score (r=-0.344, P < 0.01);the psychological resilience score was negatively correlated with the anxiety symptom score (r=-0.495, P < 0.01). The hierarchical regression analysis results found that stress had a positive effect on anxiety symptoms (b=0.280, P < 0.01), and a negative effect on psychological resilience (b=-0.344, P < 0.01);psychological resilience negatively affected anxiety symptoms (b=-0.398, P < 0.01), and played a partial mediating role in the relationship between stress and anxiety symptoms (effect value was 0.137) that accounted for 32.8% of the total effect. [Conclusion] In the post COVID-19 period, medical students have a superposition of high stress and high anxiety symptoms. Psychological resilience is a protective factor for anxiety symptoms and plays a partial mediating role in the relationship between stress and anxiety symptoms.Copyright © 2021, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.

Nexus between green financing, renewable energy generation, and energy efficiency: empirical insights through DEA technique.

The study aims to test the nexus of green financing with renewable electricity generation and energy efficiency. The study used data envelopment analysis (DEA) technique during the year of 2016 to 2020 in developed and developing countries. The findings show that there is a 24% possibility of worldwide rise in expenditures in renewable energy through energy efficiency projects and probably could fall around 17% much further in 2017 and 2018. This may jeopardize the Sustainable Development Goals (SDGs) and the Paris climate change agreement. Lack of access to private financing slows the development of green initiatives. Now that sustainable energy is not about science and technology, it is all about getting financing in developed and developing countries. As policy measure, the study suggested to value environmental initiatives, like other infrastructure initiatives, for greater electricity generation and energy efficiency in developed and developing countries. Such infrastructural projects need long-term financing and capital intensiveness. It is further suggested to sustain growth, development, and energy poverty reduction, and around $26 trillion would be required, in terms of green financing, in the developed and developing countries alone by the year 2030 to enhance energy efficiency. To achieve energy sustainability goals in developed and developing countries, recent research suggested some policy implication considering the post COVID-19 time. If such policy implications are implemented successfully, there are chances that green financing would make energy generation and energy efficiency effective.

Tietze Syndrome as a Cause of Chest Pain in the Post-COVID-19 Period.

Tietze syndrome is a rare disease. It is mainly characterized by chest pain caused by a unilateral and monoarticular lesion of the second-fifth costal joints. Tietze syndrome is one of the potential complications in the post-COVID-19 period. It is one of the differential diagnoses for non-ischemic chest pain. With early diagnosis and appropriate treatment, this syndrome is easily manageable. The authors present a case of a 38-year-old male who had been diagnosed with Tietze syndrome in the post-coronavirus disease 2019 (COVID-19) period.

Financial inclusion role on energy efficiency financing gaps in COVID-19 period: empirical outcomes of emerging nations.

The structural imposed crises of the COVID-19 have halted the system of financial intermediation at large. By this, the energy sector needs huge financing for energy efficiency maximization in the COVID-19 crises. Thus, the current research aims to inquire the role of financial inclusion in filling the energy efficiency financing gaps for the period of COVID-19 outbreak. The governments of many countries are facing fiscal deficits and trying to survive under tight substantial fiscal limitations. So providing a cheap and efficient energy in modern times, under COVID-19 crises, is merely impossible for many economies because the main source of income for energy sector is the energy users, and having inefficient energy for consumption is raising energy poverty at large. Therefore, COVID-19 crises raised a wide energy financing gap in modern times that needs a fix. However, this research is suggesting the system to make financial inclusion structure as effective, to fill the energy financing gap, for post-COVID-19 time, and to develop a viable and sustainable financing option for energy sector in long-run perspective. This study also validated the empirical role of financial inclusion on energy poverty and energy efficiency, with historical data, to justify the significance of financial inclusion for energy financing gap fulfillment. More so, this paper is also recommending new policy implications for the stakeholders to utilize. We believe if the recommended policy recommendations are considered for practice, the energy financing gap in post-COVID-19 era would be mitigated, and there is a high probability to supply the efficient energy to the end users.

THE CLINICAL FEATURES OF RECOVERY IN PATIENTS WHO HAD CORONAVIRUS INFECTION COVID-19 BASED ON THE DURATION OF POST-COVID PERIOD AND SEVERITY OF LUNG PARENCHYMAL ABNORMALITIES

Introduction. Post-COVID syndrome is a complex of symptoms that develops in almost half of the patients who have had a new coronavirus infection (COVID-19). The frequency of symptom development based on the duration of the post-COVID period, age, gender, and severity of the course of the disease are highly relevant subjects, as they will allow to form approaches to the diagnosis, treatment, and prevention of post-COVID syndrome. Material and methods. 43 patients were included (men – 10, women – 33), age 65 [60–71]. The questionnaire was designed after a comprehensive review of literature from the past studies based on similar objectives. We divided patients in two groups in depending on recovery: up to 3 months (n=23), after to 3 months (n=20). In depend on degree of lung parenchymal abnormalities two groups were formed: less than 25%, more than 25%. Vital signs (respiratory rate, SpO2, hearth rate) were collected. The tolerance in physical activity we investigate by modified Medical Research Council breathlessness scale – mMRC, six-minute test. Borgscale, hurt rate and oxygen saturation were measured immediately before and after test. Data were analyzed using Statistical Package for Social Sciences version 22.0. Results and discussion. The majority of the patients complained on persistent fatigue (75%), dyspnea (59%), joint pain (45%), anxiety (38%) and chest pain (37%). We didn't find difference in frequencies of majority of complaints in depend on duration of post-COVID period. In patients with LA>25% mMRC, respiratory rate, Borg scale in six-minute test higher than in patients with LA<25%. Conclusion. In elderly patients, symptoms persisted for more than 3 months after a new coronavirus infection, which is associated with a higher risk of chronic pathological processes in elderly patients. With lung lesion volume of more than 25%, respiratory functional test values are higher than in the group of patients with smaller lesion volume, which is most likely caused by preserved structural damage of lung tissue. © 2022, LLC "IMC" Modern Clinical Medicine. All rights reserved.

Clinical features of post-COVID-19 period. Results of the international register "Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)". Data from 6-month follow-up

Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods. The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 - 2770. Patients diagnosed with COVID-19 receiving in-and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two non-overlapping branches (in-and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3-and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period. Copyright © 2021, Silicea-Poligraf. All rights reserved.

MORPHOLOGICAL AND FUNCTIONAL FEATURES OF THE MUCOUS MEMBRANE OF SMALL AND LARGE INTESTINE IN PATIENTS WITH COVID-19 AND IN POST-COVID-19 PERIOD.

OBJECTIVE: The aim: To reveal the morphological and functional features of the mucous membrane of small and large intestine in patients with COVID-19 and in post-COVID-19 period. PATIENTS AND METHODS: Materials and methods: In the present study, the authors used biopsy and autopsy material represented by the fragments of the mucous membrane of small and large intestine. All studied material was divided into 10 groups. Group 1 (comparison group) included autopsy material from the deceased who did not have COVID-19 during their lifetime. Groups 2-4 included autopsy material from the deceased who had COVID-19 of varying severity during their lifetime. Groups 5-7 included biopsy material from patients who had recovered from COVID-19 of varying severity, while the duration of the post-COVID period ranged from 1 to 50 days. Groups 8-10 included biopsy material from patients who had in anamnesis COVID-19 of varying severity (the duration of the post-COVID period lasted from 51 to 100 days). Histological, immunohistochemical, morphometric and statistical research methods were used. RESULTS: Results: The comparative analysis showed a more expressed deficiency of ACE2 in the mucous membrane of small and large intestine in patients with moderate and severe COVID-19 compared with patients in post-COVID-19 period of different duration. In patients who had moderate and severe COVID-19 in anamnesis, ACE2 deficiency decreases with increasing duration of post-COVID-19 period. In patients recovered from mild COVID-19, the ACE2 content increases with the duration of post-COVID-19 period from 1 to 50 days and corresponds to the norm with the duration of this period from 51 to 100 days. CONCLUSION: Conclusions: The comprehensive morphological study conducted by the authors made it possible, firstly, to clarify the morphological and functional features of the mucous membrane of small and large intestine in patients with COVID-19 of various degrees of severity; secondly, to obtain new data about the morpho-functional state of the mucous membrane of small and large intestine in patients, taking into account different duration of the post-COVID-19 period and the severity of the infection.

RHINOSINUSITIS IN PATIENTS IN POST-COVID-19 PERIOD: ETIOLOGY, CLINICAL AND MORPHOLOGICAL CHARACTERISTICS.

OBJECTIVE: The aim is to identify the etiology, clinical and morphological features of rhinosinusitis in patients in post-COVID-19 period. PATIENTS AND METHODS: Materials and methods: In the present study, it was carried out the analysis of 11 cases of rhinosinusitis, which developed after COVID-19 infection. The diagnosis of rhi¬nosinusitis was established on the basis of anamnesis, clinical and laboratory examination, specialized instrumental examination (rhinoendoscopy, X-ray, magnetic resonance imaging, spiral and 3D computed tomography). All patients underwent endoscopic sanitation of the nasal cavity, expansion of the maxillary anastomosis, maxillary sinusotomy, sanitation of the maxillary sinuses and removal of pathologically altered tissues. Microbiological examination of the swab from the nasal cavity was carried out in all patients. Histological and morphometric research methods were used during the morphological study of surgical material. The nonparametric Mann-Whitney U test was used to compare the means in the groups. RESULTS: Results: The conducted comprehensive study made it possible to identify chronic atrophic rhinosinusitis at the stage of exacerbation caused by associations of bacteria and fungi in patients in post-COVID-19 period. Among bacteria, the authors most often noted Staphylococcus aureus, Staphylococcus epidermidis, Klebsiella pneumonia, Streptococcus pneumonia and Enterococcus faecalis. Among fungi, there were Aspergillus, Candida, Mucor and Coccidioides. Fungal infection was characterized by invasion into the mucous membrane of the nose and paranasal sinuses. In patients in post-COVID-19 period the invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation was predominantly bilateral, characterized by the involvement of several or all paranasal sinuses in the process. Patients with such pathology complained of periodic fever, headaches and malaise; nasal congestion and constant difficulty in nasal breathing; yellowish-greenish-reddish discharge from the nasal cavity, sometimes with a fetid odor; discomfort and pain in the area of paranasal sinuses; immobility of the eyeball, hyposmia or anosmia; reduction or complete loss of vision. Frequent risk factors for the development of invasive bacterial-fungal chronic atrophic rhinosinusitis at the stage of exacerbation in patients in post-COVID-19 period were the information about moderate or severe course of this infection in anamnesis; comorbidities (predominantly diabetes mellitus, hypertensive disease and ischemic heart disease). CONCLUSION: Conclusions: The study conducted by the authors made it possible to identify the etiological, clinical and morphological features, as well as risk factors of rhinosinusitis in patients in post-COVID-19 period. This information will contribute to a better understanding of such pathology by the doctors and improve the diagnostic and treatment process.

Problems About Learning Attitude of Undergraduate Students in the Post-Covid Period in Vietnam

A good study attitude is one of the decisive factors leading to good academic results and the completion of the capacity and personality of any undergraduate student. However, the study attitude of most Vietnamese students today has many significant problems after being long and profoundly affected by COVID-19. By surveying 120 undergraduate students, the author analyzed the above situation using qualitative and quantitative methods. Since then, many urgent problems need to be recognized and handled as soon as possible, of which there are five typical problems: (1) The time for studying has many changes, (2), The form of assessment of subjects is more difficult, (3) Learners need to be more active, (4) The cost of studying increases (5) Limited multitasking habits, (6) There are many knowledge gaps in the online learning phase, and (7) Still need to be careful in epidemic prevention Based on that, the author has also proposed solutions for universities and families to help undergraduate students overcome those difficulties as soon as possible, in the most effective way.

QUALITY MANAGEMENT IN INDUSTRY 4.0 IN THE POST-COVID-19 PERIOD FOR ECONOMIC SECURITY AND SUSTAINABLE DEVELOPMENT

Unexpected shock hit the world economy in February 2020 when the spread of the COVID-19 virus began worldwide. In this regard, the technology of Industry 4.0 can be an important tool for economic recovery by allowing for sustainable product change. Therefore, it is necessary to measure the global readiness of Industry 4.0 to guide policies in defining the benefits of promoting Industry 4.0 and to unlock its potential in the event of an pandemic (Javaid et al., 2020).In this context, the paper aims to understand the readiness and responsiveness of the various regions in terms of Industry 4.0 before the pandemic and to identify best practices to support companies acquired by Industry 4.0, with a focus on those that promote sustainable practices. The framework for pre-pandemic testing is provided based on two components: the readiness of the firms to invest in Industry 4.0 and the excellent scenario. The study shows a group of regions that are more cautious than the inequality group, especially those related to diversity in the North and South. Considering how “vigilant regions” are likely to successfully manage and overcome the post-COVID-19 problem, it provides an overview of how various regions have sought to promote the adoption of digital technology to improve resilience after a shock. Analysis shows that funding mechanisms are targeted at small and medium enterprises. In addition, tenders promoting the acquisition of Industry 4.0 indicate that collaboration between stakeholders will be critical © 2022. International Journal for Quality Research.All Rights Reserved.

Exploring the Necessity of Psychological Rounds and Psychological Interventions in General Hospitals in the Post-COVID-19 Period.

Objective: To explore the necessity of psychological rounds and psychological intervention in the post-COVID-19 period in a general hospital. Methods: Based on the current pandemic influence on Chinese people's psychology, the medical experience, and environment were analyzed, and the feasibility of psychological evaluation and intervention were appraised with the psychological changes that might be brought by the medical behaviors, especially for surgical operations. Results: Nowadays, the pandemic is under full control in China, although the pandemic is rampant abroad. In China, the "Normalized pandemic prevention" phase has begun. In the post-COVID-19 period, the prolonged pandemic has made numerous people pessimistic, angry, and other negative emotions. Several general hospitals are facing huge influences: under the influence of anxiety, such as "higher hospital-acquired infection rate," the patient attendance rate is reduced, and the hospital income is sharply reduced. Doctor-patient conflicts are more likely to occur during the medical procedures, affecting the medical experience, and reducing the rate of re-visit and referral. Conclusion: After analyzing a series of "endogenous" and "exogenous" factors of medical procedures in a general hospital in the post-pandemic period, it suggests that anxiety and depression caused by uncertainties in the medical procedures may be more obvious. Also, it is necessary to pay attention to the psychological status of patients and carry out psychological rounds and psychological interventions in general hospitals. The service quality can be improved, the medical experience can be ameliorated, and it can help general hospitals to turn "crisis" into "opportunity," which also brings better development.

Examining the critical factors of computer-assisted audit tools and techniques adoption in the post-COVID-19 period: internal auditors perspective

Purpose - In light of the repercussions of the COVID-19 pandemic, electronic auditing otherwise known as computer-assisted audit tools and techniques (CAATTs) has become inevitable to automate the auditing process worldwide. Accordingly, the purpose of this study is to examine the influence of technological, organizational and environmental (TOE) factors on public sector adoption of CAATTs in developing countries such as Jordan under the COVID-19 pandemic conditions. Design/methodology/approach - This study used 136 usable responses from the managers of internal audit (IA) of the Jordanian public sector entities. The data collected were analyzed using partial least squares-structural equation modeling. The TOE framework has been used in this study to consider a wide set of TOE factors. Then, this study suggests a CAATTs adoption model that incorporates the related technology factors of the diffusion of innovation theory to environmental and organizational factors. Further, this study contributes to the TOE framework by addressing government regulations, audit bodies' support and audit task complexity as environmental factors affecting CAATTs adoption in the context of the public sector. Findings - The results revealed that for technological factors, only the compatibility affects CAATTs adoption by the IA departments. For organizational factors, organizational readiness, top management support, auditors' information technology competency and entity size were found to be significant factors. From the environmental factors, both government regulation and audit task complexity influence the CAATTs adoption. Betides, entity size moderates the influence of top management support on the CAATTs adoption in the public sector. Practical implications - The findings could highlight the significance of the CAATTs adoption in the public sector institutions (by internal auditors) post-COVID-19, taking into consideration the TOE framework's factors. Also, the findings are significant for the decision-makers and regulators in declaring new legislation for the electronic IA profession in theJordanian public sector. Social implications - It turns out that the CAATTs adoption in the public sector can definitely enhance their ability to achieve the role of IA in preserving public funds and restricting corrupt practices within the public sector. Originality/value - To the best of the authors' knowledge, this study is one of the first studies that address the professional audit agency support and audit task complexity as environmental factors, as well as the entity size as an organizational factor, that affect CAATIs adoption in the IA department of the public sector.

Unexpected Increases of Severe Haze Pollution During the Post COVID-19 Period: Effects of Emissions, Meteorology, and Secondary Production

Unexpectedly frequent severe haze episodes were observed in Beijing during February-March in 2021 after two phases of clean air action plan (2013-2020), yet the causes remained unclear. Here, we conducted real-time fine particle (PM2.5) composition measurements during January-March in 2021 using a time-of-flight aerosol chemical speciation monitor and an aethalometer and compared with those during the coronavirus disease (COVID-19) period in 2020. Our results showed ubiquitously elevated concentrations of chloride, black carbon (BC), and primary organic aerosol (POA) in 2021, suggesting increased primary emissions during the post-COVID-19 period. By using the machine learning-based random forest (RF) algorithm, we found largely different responses of aerosol changes to meteorology in different months. After decoupling the effects of meteorology, the PM2.5 changes from 2020 to 2021 were reduced from -35.6% to -29.0% in January, -24.1% to -4.5% in February, and +92.6% to +34.2% in March, respectively. Our results demonstrate the dominant roles of stagnant meteorology and secondary production in the formation of severe haze episodes in March 2021. In particular, we found that the compositions of observed and deweathered PM2.5 were fairly similar between 2020 and 2021, and the ratios of secondary OA to secondary inorganic aerosols were close. Our study indicates that decoupling the influence of meteorological conditions is of great importance for better evaluation of mitigating strategies of air pollution due to the large impact of meteorology on the changes in PM2.5 species particularly in a short period.

Analysis of Doctor-Patient Relationship in Post-COVID-19 Period: Perspective Differences Between Citizen and Medical Staff.

To evaluate the current views on doctor-patient relationship (DPR) between citizens and medical staff in post-Corona Virus Disease 2019 (COVID-19) period and predict the possible factors of DPR, we distributed questionnaires by a online questionnaire platform--Questionnaire Star (https://www.wjx.cn) to evaluate DPR in post-COVID-19 period. Overall, 312 questionnaires for citizens and 421 questionnaires for medical staff were completed. Citizens felt that service attitude and communication with medical staff, and registering process have been improved. And their trust in doctors has increased by 86.8%. Majority of citizens (66.0%) preferred the tertiary hospitals. If doctor-patient contradictions occurred, 62.9% citizens preferred internal negotiation (with the doctor involved, 44.6%; with hospital management department, 18.3%). There was significant difference of views on the causes of medical violence incidents and the reasons for doctor-patient conflicts in the future between citizens and medical staff. The DPR score of medical staff was lower than citizens at each stage, and even showed a downward tendency in post-COVID-19 period. Furthermore, 20.4% medical staff believed that harmonious DPR would not be maintained, which was distinct from that of the citizens. Combating the COVID-19 provided an important opportunity to improve the DPR. However, unbalanced allocation of high-quality medical resources, gap between the actual treatment efficacy and patient's expectation, fairness and efficiency issues, financial conflicts, and medical information symmetry were still the influencing factors of DPR.

[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.