合并症在Long-COVID发展中的作用

T.V. Chernii, V.I. Chernii, D.A. Fokina
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A clinical and neurological examination of 50 patients aged 47 to 76 years with a diagnosis of chronic cerebral ischemia and an asthenic syndrome that persisted for more than 3 months after a confirmed SARS-CoV-2 infection was carried out. All patients were treated according to a clinical protocol approved by the MOH of Ukraine. In addition to the main treatment, 20 patients received a 10-day course of infusions of a combination of the drugs Xavron in a dose of 30 mg No. 10, Tivorel 100.0 No. 5 and Xylate 200.0 No. 5 every other day. Efficacy was assessed before treatment, on the 5th and 10th day of treatment using the MMSE, DASS-21, FAS and MOND scales.&#x0D; RESULTS AND DISCUSSION. A stable positive relationship was found between the number of CIRS-G comorbidity scores and the MOND score. A positive correlation coefficient between comorbidity and asthenic syndrome, assessed on the FAS scale, was also expressed – 0.699 (p<0.001). A somewhat weaker negative relationship was found between anxiety and the number of points on the CIRS-G scale – -0.474 (p=0.035). Assessment of depression and stress on the DASS-21 scale did not show a reliably significant correlation effect. After treatment, the severity of neurological symptoms, assessed by the MOND scale, decreased from 5.6±1.6 to 2.8±1 (p<0.01). Depression and anxiety scores on the DASS-21 scale decreased moderately from 4.9±3.6 to 2.8±1.5 (p<0.01) and from 6.3±2.3 to 4.3±1.5 (p<0.01), respectively. A more significant regression was observed on the stress scale – from 10.3±3.1 to 7.5±1.9 (p<0.01). The difference in the severity of fatigue from 28.8±4.1 to 20±1.2 was especially noticeable (p<0.01). CONCLUSIONS. Asthenic syndrome, which is prevalent in the Long-COVID, directly depends on the background of chronic diseases. The combination of Xavron, Tivorel and Xylate is pathogenetically justified and safe in the treatment of patients with Long-COVID. 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引用次数: 0

摘要

背景。后冠状病毒综合征是冠状病毒感染后患者出现的一系列症状。迄今为止,从疾病形成长期后果的发病机制的角度出发,人们仍然非常有兴趣确定伴随疾病对SARS-CoV-2感染过程的影响与选择合理的治疗方案之间的关系。目标。探讨合并症在Long-COVID发展中的作用,研究和分析Xavron、替佛瑞尔和木酸酯联合治疗Long-COVID虚弱表现患者的效果。 材料和方法。对50例年龄在47岁至76岁之间,诊断为慢性脑缺血并在确诊的SARS-CoV-2感染后持续3个多月的衰弱综合征的患者进行临床和神经学检查。所有患者均按照乌克兰卫生部批准的临床方案进行治疗。除主要治疗外,20名患者接受了为期10天的药物联合输注,剂量为30 mg No. 10,每隔一天输注一次替佛瑞尔100.0 No. 5和Xylate 200.0 No. 5。治疗前、治疗第5、10天分别采用MMSE、DASS-21、FAS、MOND量表评估疗效。结果和讨论。CIRS-G合并症评分与MOND评分呈稳定正相关。FAS量表评估的共病与衰弱综合征之间的正相关系数也为- 0.699 (p<0.001)。焦虑与CIRS-G量表得分之间存在较弱的负相关关系- -0.474 (p=0.035)。抑郁和压力在das -21量表上的评估没有显示出可靠的显著相关效应。治疗后,经MOND量表评估的神经症状严重程度从5.6±1.6降至2.8±1 (p<0.01)。抑郁和焦虑在DASS-21量表上分别从4.9±3.6分降至2.8±1.5分(p<0.01)和从6.3±2.3分降至4.3±1.5分(p<0.01)。在应力量表上观察到更显著的回归-从10.3±3.1到7.5±1.9 (p<0.01)。疲劳程度从28.8±4.1到20±1.2的差异尤为显著(p<0.01)。结论。在长冠人群中普遍存在的虚弱综合征与慢性病背景直接相关。Xavron、Tivorel和Xylate联合治疗Long-COVID患者在病理学上是合理和安全的。使用这种组合可以减少虚弱综合征,这反过来又对减少长冠状病毒以“脑雾”形式出现的认知表现产生积极影响。
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The role of comorbidity in the development of Long-COVID
BACKGROUND. Post-COVID syndrome is a set of conditions that occur in patients after a coronavirus infection. To date, there remains great interest in identifying the relationships between the influence of concomitant diseases on the course of SARS-CoV-2 infection and the selection of a justified treatment regimen from the point of view of the pathogenesis of the formation of long-term consequences of the disease. OBJECTIVE. To investigate the role of comorbidity in the development of Long-COVID, to study and analyze the results of treatment with a combination of Xavron, Tivorel and Xylate in patients with asthenic manifestations of Long-COVID. MATERIALS AND METHODS. A clinical and neurological examination of 50 patients aged 47 to 76 years with a diagnosis of chronic cerebral ischemia and an asthenic syndrome that persisted for more than 3 months after a confirmed SARS-CoV-2 infection was carried out. All patients were treated according to a clinical protocol approved by the MOH of Ukraine. In addition to the main treatment, 20 patients received a 10-day course of infusions of a combination of the drugs Xavron in a dose of 30 mg No. 10, Tivorel 100.0 No. 5 and Xylate 200.0 No. 5 every other day. Efficacy was assessed before treatment, on the 5th and 10th day of treatment using the MMSE, DASS-21, FAS and MOND scales. RESULTS AND DISCUSSION. A stable positive relationship was found between the number of CIRS-G comorbidity scores and the MOND score. A positive correlation coefficient between comorbidity and asthenic syndrome, assessed on the FAS scale, was also expressed – 0.699 (p<0.001). A somewhat weaker negative relationship was found between anxiety and the number of points on the CIRS-G scale – -0.474 (p=0.035). Assessment of depression and stress on the DASS-21 scale did not show a reliably significant correlation effect. After treatment, the severity of neurological symptoms, assessed by the MOND scale, decreased from 5.6±1.6 to 2.8±1 (p<0.01). Depression and anxiety scores on the DASS-21 scale decreased moderately from 4.9±3.6 to 2.8±1.5 (p<0.01) and from 6.3±2.3 to 4.3±1.5 (p<0.01), respectively. A more significant regression was observed on the stress scale – from 10.3±3.1 to 7.5±1.9 (p<0.01). The difference in the severity of fatigue from 28.8±4.1 to 20±1.2 was especially noticeable (p<0.01). CONCLUSIONS. Asthenic syndrome, which is prevalent in the Long-COVID, directly depends on the background of chronic diseases. The combination of Xavron, Tivorel and Xylate is pathogenetically justified and safe in the treatment of patients with Long-COVID. The use of this combination leads to a reduction of asthenic syndrome, which, in turn, has a positive effect on the reduction of cognitive manifestations of Long-COVID in the form of “brain fog”.
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