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Introduction. Studying clinical manifistations and prognostic factors for the development of post-covid syndrome (PCS) remains an actual task for doctors of various specialties.Aim. To study the clinical manifestations and probable predictors of the formation of PCS in neurological practice.Materials and methods. The study included 34 patients aged 18 to 65 years undergoing treatment at the A.Ya. Kozhevnikov Clinic of Nervous Diseases for the underlying disease: tension headaches (GBN), migraine (M), musculoskeletal pain (SMB), who had a documented coronavirus infection (CI) COVID-19. The main group (OG) consisted of 21 patients (average age 47.95 ± 12.21 years), in addition to the manifestations of the underlying disease, complaining of memory impairment, decreased concentration and performance, fatigue, anxiety and internal tension, low mood background and unwillingness to do anything, headache that occurred for the first time during, immediately after the end or within 2 months after the transferred CI, which met the criteria of the PCC. The comparison group (GS) included 13 patients (average age 38 ± 12 years) who complained only about their underlying diseases and did not note any peculiarities in their course due to the transferred CI. In addition to the main research methods, questionnaires were used: fatigue (MFI-20 scale), anxiety (Spielberger – Khanin scale), depression (Beck scale), cognitive impairment (MOCA test), impaired concentration (Munsterberg test), symptoms of central sensitization (CSI), quality of life (SF-36).Results. Clinical manifestations of PKS consisted in mild or subjective cognitive impairment (CN) without a change in concentration and asthenic symptom complex. OG patients were older, had moderate and severe acute period of CI and risks of cardiovascular pathology, statistically significantly differed from HS with higher scores on the scales: Beck depression, Spielberger – Khanin, CSI, MFI-20 and a lower score on the MOCA scale.Conclusions. Possible predictors of the formation of PKS can be: age over 40 years, moderate and severe course of CI, the presence of risks of cardiovascular pathology, depression and increased personal anxiety, higher rates of central sensitization.
Introduction. Studying clinical manifistations and prognostic factors for the development of post-covid syndrome (PCS) remains an actual task for doctors of various specialties.Aim. To study the clinical manifestations and probable predictors of the formation of PCS in neurological practice.Materials and methods. The study included 34 patients aged 18 to 65 years undergoing treatment at the A.Ya. Kozhevnikov Clinic of Nervous Diseases for the underlying disease: tension headaches (GBN), migraine (M), musculoskeletal pain (SMB), who had a documented coronavirus infection (CI) COVID-19. The main group (OG) consisted of 21 patients (average age 47.95 ± 12.21 years), in addition to the manifestations of the underlying disease, complaining of memory impairment, decreased concentration and performance, fatigue, anxiety and internal tension, low mood background and unwillingness to do anything, headache that occurred for the first time during, immediately after the end or within 2 months after the transferred CI, which met the criteria of the PCC. The comparison group (GS) included 13 patients (average age 38 ± 12 years) who complained only about their underlying diseases and did not note any peculiarities in their course due to the transferred CI. In addition to the main research methods, questionnaires were used: fatigue (MFI-20 scale), anxiety (Spielberger – Khanin scale), depression (Beck scale), cognitive impairment (MOCA test), impaired concentration (Munsterberg test), symptoms of central sensitization (CSI), quality of life (SF-36).Results. Clinical manifestations of PKS consisted in mild or subjective cognitive impairment (CN) without a change in concentration and asthenic symptom complex. OG patients were older, had moderate and severe acute period of CI and risks of cardiovascular pathology, statistically significantly differed from HS with higher scores on the scales: Beck depression, Spielberger – Khanin, CSI, MFI-20 and a lower score on the MOCA scale.Conclusions. Possible predictors of the formation of PKS can be: age over 40 years, moderate and severe course of CI, the presence of risks of cardiovascular pathology, depression and increased personal anxiety, higher rates of central sensitization.
Background: depressions in elderly and senile patients often occur against the background of cerebral changes of vascular and atrophic origin and are combined with impaired cognitive functions. It is known that a decrease in the production of neurotrophic factors is one of the leading mechanisms in the pathogenesis of depression. Previously, the effectiveness of combined therapy with antidepressants and drugs with neuroprotective properties has been shown, but a differentiated approach to the appointment of neuroprotective adjuvants needs substantiation. The aim of the study was to carry out comparative evaluation of the effectiveness of two augmentation methods of antidepressant therapy with the inclusion of different neuroprotectors (actovegin or cerebrolysin) in the treatment of depression in the elderly. Patients and methods: the study included 2 groups of patients with a depressive episode of mild and moderate severity, comparable in terms of basic demographic and clinical parameters. Patients of the 1st group received antidepressants in combination with actovegin for a month. Patients of the 2nd group received cerebrolysin simultaneously with antidepressants. The effectiveness of therapy was assessed on the HAMD-17 and HARS scales; the level of cognitive functioning of patients was assessed using the MMSE scale. Results: the effectiveness of both used types of complex antidepressant therapy was demonstrated: both with the inclusion of actovegin and with the inclusion of cerebrolysin. In patients of both groups, against the background of a reduction in depressive symptoms, a significant (p < 0.01) improvement in cognitive functioning (according to the MMSE scale) was noticed by the end of therapy (without statistically significant differences between the groups). The inclusion of actovegin in the antidepressant therapy regimen for elderly patients proved to be effective regardless of the type of depression, but especially in the reduction of anxiety symptoms. Administration of cerebrolysin to depressed patients was more effective in anergic, asthenic, apathetic and adynamic depressions. Conclusion: augmentation of antidepressant therapy with actovegin and cerebrolysin should be considered effective and recommended for use in a psychogeriatric hospital.
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