Laboratory, clinical, neurological and neuropsychological features of the course of post-COVID syndrome in patients with cerebrovascular disease

V.V. Marshtupa, T.I. Nasonova
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Abstract

A review of the literature reveals a wide range of terms for conditions after coronavirus disease (COVID-19): post-­COVID syndrome, post-acute COVID syndrome, chronic COVID-19, long-term complications of COVID-19, long COVID-19, and post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection. All these terms and others indicate that after ­COVID-19, a person does not return to his/her usual state of health. Many scientists are researching and looking for the causes of these symptoms, why and when they occur, and how to diagnose and treat them. Therefore, the aim of the study was to improve the diagnosis of post-COVID syndrome in patients with cerebrovascular disease (CVD) by studying clinical, neurological, laboratory and neuropsychological markers. Materials and methods. The study uses psychometric methods — Beck Anxiety Inventory, Hamilton Depression Rating Scale, Fatigue Assessment Scale; neuropsychological — Montreal Cognitive Assessment; clinical — neurological status; laboratory — hemoglobin, C-reactive protein, fibrinogen, albumin, ferritin, lactate dehydrogenase. All patients were divided into four groups: the first group included 20 people with post-­COVID syndrome and CVD, the second — 15 individuals with post-COVID syndrome without CVD, the third — 15 patients without post-COVID syndrome with CVD, and the fourth — 15 people without post-COVID syndrome and without CVD. Results. In the group of patients with post-COVID syndrome with cerebrovascular disease (n1 = 20), the average level of hemoglobin (M = 115.15 ± 4.93) and albumin (M = 32.15 ± 1.53) was below the normal range; the content of fibrinogen (M = 6.04 ± 0.82), C-reactive protein (M = 5.50 ± 0.68) was above normal. Data of the Hamilton Depression Rating Scale indicate that patients with post-COVID syndrome and cerebrovascular disease Data of the Hamilton Depression Rating Scale indicate that patients with post-COVID syndrome and cerebrovascular disease (n1 = 20) had a mild depression (M = 6.75 ± 3.90; M = 8.60 ± ± 3.06). Correlation analysis revealed a direct relationship between cognitive functions and hemoglobin (r = 0.455, p ≤ 0.01), albumin (r = 0.571, p ≤ 0.01) and an inverse relationship between cognitive functions and fibrinogen (r = –0.605, p ≤ 0.01), C-reactive protein (r = –0.547, p ≤ 0.01), ferritin (r = 0.408, p ≤ 0.01). There was an inverse correlation between anxiety and hemoglobin (r = –0.619, p ≤ 0.01) and albumin (r = –0.567, p ≤ 0.01) and a direct relationship between anxiety and fibrinogen (r = 0.550, p ≤ 0.01) and C-reactive protein (r = 0.537, p ≤ 0.01). The depression scale negatively correlates with the level of hemoglobin (r = –0.597, p ≤ 0.01), albumin (r = –0.543, p ≤ 0.01) and directly with the content of fibrinogen (r = 0.433, p ≤ 0.01), C-reactive protein (r = 0.383, p ≤ 0.01) and lactate dehydrogenase (r = 0.276, p ≤ 0.05). The indicators of fibrinogen, C-reactive protein, and ferritin were the highest in the group of patients with post-COVID syndrome and cerebrovascular disease. According to the obtained data, there are statistically significant differences between four groups in cognitive functions (χ2 = 36.419, p ≤ 0.01), fatigue (χ2 = 37.251, p ≤ 0.01), anxiety (χ2 = 37.981, p ≤ 0.01) and depression (χ2 = 37.171, p ≤ 0.01). The highest rate of fatigue, anxiety, and depression was found in patients with post-COVID syndrome and cerebrovascular disease.
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脑血管病患者covid - 19后综合征病程的实验室、临床、神经学和神经心理学特征
对文献的回顾揭示了冠状病毒病(COVID-19)后症状的广泛术语:COVID后综合征,急性后COVID综合征,慢性COVID-19, COVID-19的长期并发症,长期COVID-19和严重急性呼吸系统综合征冠状病毒感染的急性后后遗症。所有这些术语和其他术语都表明,在covid -19之后,一个人不会恢复到他/她通常的健康状态。许多科学家正在研究和寻找这些症状的原因,它们发生的原因和时间,以及如何诊断和治疗它们。因此,本研究的目的是通过研究临床、神经学、实验室和神经心理学指标,提高对脑血管病(CVD)患者后冠状病毒综合征的诊断。材料和方法。本研究采用心理测量方法-贝克焦虑量表、汉密尔顿抑郁评定量表、疲劳评定量表;神经心理学-蒙特利尔认知评估;临床-神经系统状况;血红蛋白,c反应蛋白,纤维蛋白原,白蛋白,铁蛋白,乳酸脱氢酶。所有患者被分为四组:第一组包括20名患有后冠综合征和心血管疾病的患者,第二组15名患有后冠综合征但不患有心血管疾病的患者,第三组15名没有后冠综合征但患有心血管疾病的患者,第四组15名没有后冠综合征但不患有心血管疾病的患者。结果。新冠肺炎后合并脑血管病患者组(n1 = 20)血红蛋白(M = 115.15±4.93)、白蛋白(M = 32.15±1.53)平均水平低于正常范围;纤维蛋白原(M = 6.04±0.82)、c反应蛋白(M = 5.50±0.68)均高于正常水平。汉密尔顿抑郁评定量表数据显示,新冠肺炎后综合征和脑血管病患者(n1 = 20)存在轻度抑郁(M = 6.75±3.90;M = 8.60±±3.06)。相关分析显示,认知功能与血红蛋白(r = 0.455, p≤0.01)、白蛋白(r = 0.571, p≤0.01)呈正相关,与纤维蛋白原(r = -0.605, p≤0.01)、c反应蛋白(r = -0.547, p≤0.01)、铁蛋白(r = 0.408, p≤0.01)呈负相关。焦虑与血红蛋白(r = -0.619, p≤0.01)、白蛋白(r = -0.567, p≤0.01)呈负相关,与纤维蛋白原(r = 0.550, p≤0.01)、c反应蛋白(r = 0.537, p≤0.01)呈正相关。抑郁量表与血红蛋白(r = -0.597, p≤0.01)、白蛋白(r = -0.543, p≤0.01)水平呈负相关,与纤维蛋白原(r = 0.433, p≤0.01)、c反应蛋白(r = 0.383, p≤0.01)、乳酸脱氢酶(r = 0.276, p≤0.05)含量直接相关。纤维蛋白原、c反应蛋白、铁蛋白等指标均以冠状病毒后综合征合并脑血管病患者组最高。所得数据显示,四组患者在认知功能(χ2 = 36.419, p≤0.01)、疲劳(χ2 = 37.251, p≤0.01)、焦虑(χ2 = 37.981, p≤0.01)、抑郁(χ2 = 37.171, p≤0.01)方面差异均有统计学意义。疲劳、焦虑和抑郁的发生率最高的是后冠状病毒综合征和脑血管疾病患者。
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