Delayed mental, neurological and somatic disorders associated with COVID-19

Abstract

Purpose of the study. To assess the nature of health complaints, frequency of occurrence, structure and characteristics of neurological, general somatic and mental disorders in people in the post-COVID period.Materials and methods. The main group (n=1000) was represented by people who had a new coronavirus infection, confirmed by polymerase chain reaction (PCR) SARS-CoV-2, from 18 to 60 years old. As part of the study, an extensive survey of the examined individuals was carried out, aimed at identifying the main psychoneurological and general somatic consequences that developed in the period from 4 weeks to 12 months after COVID-19.Results and discussion. The study included 289 men and 711 women (28.9% and 71.1%, respectively). The average age at the time of the examination was 40.2±11.8 years. More than half of the respondents were of working age, had a permanent job or were studying (72.3%), while 17.9% indicated a high level of physical activity before COVID-19. The majority of respondents suffered from mild COVID-19 (76.6%), in 23.4% of cases the disease was moderate. Among somatic (vegetative) disorders as a consequence of COVID-19, the most common complaints were hair loss (49.5%), fatigue in 77.5% of cases, regardless of workload and type of work, and fluctuations in blood pressure in 50.2% of patients. Women complained more intensely about hair loss (χ2=60.2608, df=9, p<.001), shortness of breath (χ2=17.5025, df=9, p=0.04), interruptions in heart function (χ2=22.7863, df=9, p=0.007).Among the respondents, the most common complaints were emotional disturbances, which determined the picture of anxiety and depressive disorders, as well as cognitive impairments in the form of memory loss (69.5%), concentration, difficulties with long-term attention maintenance (65,5%) and switching from one task to another (60%). With the age of the respondents, fatigue increased in intensity (R=0.2, p<0.05), insomnia (R=0.2, p<0.05), anxiety for health and for their close persons (R=0.2, p<0.05), neurological complaints (widespread muscle pain (R=0.3, p<0.05), pain in the spine (R=0.3, p<0.05), gait disturbances (R=0.2, p<0.05), as well as the intensity of general somatic complaints (urinary disorders (R=0.2, p<0.05), shortness of breath (R=0.2, p<0.05), pain and heaviness in the chest (R=0.2, p<0.05), irregular heartbeat (R=0.2, p<0.05), fluctuations in blood pressure (R=0.2, p<0.05). Clear gender differences in the intensity of post-COVID psychopathological manifestations were revealed. Women complained more strongly about post-COVID high fatigue (χ2=23.8901, df=9, p=0.004), general malaise (χ2=17.9304, df=9, p=0.04) and, accordingly, lower activity and inability to cope with household workload (χ2=22.3384, df=9, p=0.008) compared to men. Women had more severe dysmnestic disorders (χ2=23.0900, df=9, p=0.006) than men. Women were also characterized by having greater anxiety for close persons (χ2=20.5941, df=9, p=0.01) and insomnia (χ2=20.2633, df=9, p=0.02) than men. Post-COVID neurological disorders, despite their lower frequency and intensity of manifestations, caused the most significant difficulties in everyday life and predominated in older people.Conclusion. The clinical picture of post-COVID syndrome is represented by a wide range of somatic and neuropsychiatric disorders, which determines the specifics of patient management after the illness. When assessing long-term disorders, it is advisable to rely on the opinions of specialists as part of an interprofessional expert group, to make decisions on the implementation of a clinical diagnostic algorithm for each patient based on a systematic approach, taking into account specific symptoms or conditions. Preliminary results of our study showed that special attention should be paid to women at the stage of treatment of acute infection and rehabilitation, due to the higher incidence of psychoneurological complications of COVID-19 in them. Given the risks of long-term consequences of COVID-19 and the possibility of reinfection, it is critical to integrate basic and clinical research data to optimize cognitive preservation and quality of life for patients.