[Cerebral venous thrombosis associated with COVID-19]. / Tserebral'nye venoznye trombozy, assotsiirovannye s COVID-19.

The literature reports that cerebral venous thrombosis (CVT) develops in 1-1.5% of patients with COVID-19. Recently, a new syndrome named vaccine-induced immune thrombotic thrombocytopenia (VITT) has been described. VITT is a rare side-effect of COVID-19 vaccination that also causes CVT. The article presents an overview of the above problem and a clinical case of a patient with CVT that developed within a month after the first component of the Sputnik V vaccination and COVID-19.

[Effectiveness of the anxiolytic Anvifen in the treatment of post-COVID brain fog]. / Effektivnost' preparata Anvifen pri lechenii patsientov s sindromom postkovidnogo «tumana v golove¼.

OBJECTIVE: To determine the significance of anxiety disorder and comorbid disorders in patients with post-covid brain fog, to determine the effectiveness of the GABAergic nootropic drug with an anxiolytic effect - Anvifen. MATERIAL AND METHODS: 92 post-COVID-19 patients with no organic brain damage who complain of brain fog 12 weeks after the onset of COVID-19 symptoms. Group 1 (n=40; 43.4±4.5 years) were treated at home; group 2 (n=32; 44.9±5.5 years) were treated in a hospital without oxygen support; group 3 (n=20; 45.1±4.8 years) were treated in a hospital with oxygen support. Assessment scales: Hospital Anxiety and Depression Scale (HADS), Montreal Cognitive Assessment Scale (MoCA); Trail Making Test part B (TMT-B); a scoring questionnaire for the subjective characteristics of sleep; Fatigue Assessment Scale (FAS), 36-Item Short Form Survey (SF-36). According to the indicated scales, no statistically significant differences were found between the groups, therefore, the data of all patients were combined into one group, the indicators were compared before and after treatment (Anvifen 500 mg three times a day for 21 days). RESULTS: Results before/after treatment: HADS anxiety 10.5 [8.5;12]/7 [5;8] (p=0.000025); HADS depression 5 [4; 7] / 4 [4; 6] (p=0.00003); MoCA 22 [21; 22] / 25 [24; 26] (p=0.00001); TMT-B 281 [279; 290] sec / 231 [220; 236] sec (p=0.00001); FAS 27 [23; 31] / 20 [23; 31] (p=0.00001); questionnaire for scoring the subjective characteristics of sleep 15 [15; 16] / 25 [25; 26] (p=0.00001); SF-36 Physical Health 43.8 [42.3; 47.4] / 53.8 [52.3; 20] (p=0.00001); SF-36 Mental Health 34 [32.5; 35] / 47 [45.5; 48] (p=0.00001). CONCLUSION: The authors conclude that anxiety disorder and asthenia play an important role in the pathogenesis of post-COVID brain fog syndrome. Anvifen effectiveness is considered from the point of view of the participation of GABAergic structures in the pathogenesis of the phenomenon under study.

ACUTE ONSET of CHRONIC INFLAMMATORY DEMYELINATING POLYNEUROPATHY in COMBINATION with COVID-19

Acute onset of chronic inflammatory demyelinating polyneuropathy (A-CIDP) presents significant difficulties in differential diagnosis with acute inflammatory demyelinating polyneuropathy (AIDP). The article presents review of literature about differential diagnosis between A-CIDP and AIDP and a clinical case of A-CIDP at 26-year-old man. The disease started after vaccination against influenza and an episode of enteritis, the clinical picture matched Guillain-Barré syndrome criteria, according to electromyography data: demyelinating lesion of the left facial nerve, motor and sensory fibers of the median and ulnar nerves on both sides, demyelinating lesions of motor fibers of the tibial nerve and peroneal nerve on both sides. Chronic inflammatory demyelinating polyneuropathy was diagnosed. Lack of effect from plasma exchange was the reason for changing the treatment to pulse therapy with prednisolone (with a subsequent transition to a 1 mg/kg dose and further reduction until canceled within 16 weeks). Response to prednisolone - rapid recovery of motor functions, which worsened significantly due to a new coronavirus infection during treatment in the neurology department. Further continuation of prednisolone therapy made it possible to restore motor functions completely, except mild prosopoparesis. At the same time, deep reflexes were absent;no significant EMG dynamics was observed. Considering the effect of glucocorticosteroids and lack of positive dynamics on the second electromyography, the patient was diagnosed as A-CIDP. © 2021 Volgograd State University. All rights reserved.