Стойкие когнитивные нарушения наблюдаются у значительного числа пациентов после перенесенной коронавирусной инфекции (COVID-19). Необходимы исследования, чтобы изучить структуру когнитивных изменений, динамику их появления и длительность сохранения. Целью нашего исследования было охарактеризовать динамику и структуру когнитивных нарушений у пациентов, перенесших коронавирусную инфекцию средней степени тяжести, через 6 и 12 месяцев после выписки из стационара. В исследовании приняли участие 200 пациентов с подтвержденным диагнозом «новая коронавирусная инфекция COVID-19 средней степени тяжести, осложненная дыхательной недостаточностью на фоне двусторонней полисегментарной вирусной пневмонии, вызванной SARS-CoV-2», в возрасте от 24 до 92 лет. Пациенты были разделены на две возрастные группы до и после 65 лет, каждая группа делилась на подгруппы соответственно полу. Когнитивное обследование проводилось дважды – через 6 и 12 месяцев после выписки из стационара. Когнитивные функции оценивали с помощью модифицированной Адденбругской когнитивной шкалы и батареи тестов для оценки лобной дисфункции. Все участники исследования имели нарушения хотя бы в одном когнитивном домене вне зависимости от возраста и пола. Наиболее уязвимыми когнитивными функциями после коронавирусной инфекции оказались антероградный и ретроградный компоненты памяти и речевая активность. Число баллов по данному домену находилось в диапазоне значений от 22,6 ± 2,5 до 17,6 ± 4,3 балла. При этом у обследуемых отмечалась отчетливая тенденция к постепенному снижению данной функции к 12-му месяцу после выписки из стационара. Речевая активность была существенно снижена во всех возрастных группах – у пациентов из первой группы в динамике средний балл составлял 11,2 ± 0,8 через 6 месяцев и 9,9 ± 1,0 балла через 12 месяцев, а во второй группе – 8,4 ± 2,1 и 8,7 ± 2,2 балла соответственно. Установлено, что в отдаленном периоде после перенесенной коронавирусной инфекции возникают серьезные когнитивнные нарушения как у молодых пациентов, так и у людей старшего возраста. Persistent cognitive impairment is observed in a significant number of patients after coronavirus infection (COVID-19). Research is needed to study the structure of cognitive changes, the dynamics of their occurrence and the duration of their persistence. The purpose was to study the dynamics and structure of cognitive impairment in patients who had a moderate coronavirus infection within 12 months after discharge from the hospital. The study involved 200 patients with a confirmed diagnosis of a moderately severe novel coronavirus infection COVID-19, complicated by respiratory failure against the background of bilateral polysegmental viral pneumonia caused by SARS-CoV-2, aged 24 to 92 years. All patients were divided into two main groups by age: the first – persons under 65 years of age, the second – persons over 65 years of age, each group was divided into a subgroup by gender. Conducting a cognitive examination was carried out twice – 6 and 12 months after discharge from the hospital. Cognitive function was assessed using the modified Addenbrugs Cognitive Scale and frontal dysfunction test battery. All study participants had impairments in at least one cognitive domain, regardless of age and gender. The most vulnerable cognitive functions during coronavirus infection were the anterograde and retrograde components of memory and speech activity. The number of points for this domain ranged from 22,6 ± 2,5 to 17,6 ± 4,3. At the same time, the subjects showed a clear trend towards a gradual decrease in this function by 12 months after discharge from the hospital. Speech activity was significantly reduced in all age groups – in patients from the first group in dynamics, the average score was 11,2 ± 0,8 after 6 months and 9,9 ± 1,0 after 12 months, and in the second group 8,4 ± 2,1 points and 8,7 ± 2,2 points, respectively. Our study showed that after a coronavirus infection in the long term, serious cognitive impairments occur in both young and older patients.
Background: Studies of the neurological and psychiatric consequences of coronavirus infection are of particular relevance due to their lack of knowledge. Molecular patterns of nerve tissue damage are an important task for understanding the underlying mechanisms of neurodegeneration. Aims: To study the dynamics of changes in the content of markers of neurodegeneration and neuroplasticity in patients with coronavirus infection in the acute and long-term periods. Materials and methods: A total of 200 patients aged 51 to 83 years were included and divided into two groups - the first from 51 to 65 years, the second - from 66 to 83 years. Neurodegeneration markers were determined in blood serum: neurofilament heavy chains (NEFH), S100 A6 protein, S100 B protein, -amyloid 142 (Ab1-42), microfilament associated tau protein (MAPt), serum amyloid P (SAP), and neuroplasticity: neurotrophin 3 (NT3), neurotrophin 4 (NT4). The study was performed three times - in the acute period of the disease at the time of admission to the hospital and after discharge after 6 and 12 months. Results: Women of the first group in the acute period of coronavirus infection had higher concentrations of S100 A6 (3.20.2), S100 B (0.40.06), NT3 (1.10.1), MAPt (0.130.02), while in men the values of NEFH (0.150.03), Ab1-42 (2.10.1), SAP (4.50.06 ). In the long-term period, there was a general tendency in young men to a long and high persistence of markers of neurodegeneration and neuroprotection compared to women, which indicates a long period of rehabilitation. After 12 months, the level of calcium-binding proteins S100 A6 and S100 B in men was 1.5 0.2 pg / ml and 0.3 0.04 ng / ml, and in women 1.1 0.1 pg / ml and 0.20.04 ng/ml, respectively. The level of SAP in men in the long-term period after 12 months was 4.30.1 versus 3.90.2 ng/ml in women, which is a significant difference. Analyzing the results obtained in patients of the second group, it was found that the amount of S100 A6, Ab1-42 in the acute period in women is higher, while men had higher levels of S100 B, NT3, SAP Conclusion: The revealed changes in patients with coronavirus infection both in the acute and late periods indicate active neurodegeneration processes in different age groups, which is manifested by an increase in the concentration of specific proteins in the blood serum.
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