The role of comorbidity in the development of Long-COVID

Introduction. Elimination of intracellular energy deficit and "smoldering" systemic inflammation, as well as elimination of water-electrolyte and metabolic disorders can be singled out as the main directions of therapy for the long-term consequences of Long COVID. The aim: to study and analyze the results of treatment with a pathogenetically justified combination of drugs Xavron, Tivorel and Xylat in patients with asthenic manifestations in the framework of Long-COVID. Materials and methods. During 2021, a clinical and neurological examination of 50 patients aged 47 to 76 years with a diagnosis of chronic cerebral ischemia (CMI) and an asthenic syndrome that persisted for more than 3 months after a laboratory-confirmed SARS-CoV-2 infection was carried out. The diagnosis was confirmed by the results of a clinical-neurological and neuropsychological examination using scales for the assessment of cognitive function (MMSE), emotional status (DASS-21), fatigue (FAS) and the neurological deficit assessment scale (MOND) developed by us. 20 patients additionally received a 10-day course of infusions of a combination of Xavron drugs in a dose of 30 mg No. 10, Tivorel 100.0 No. 5, and Xylate 200.0 No. 5 every other day, respectively. Thus, 50 patients were divided into two groups: the first - 20 people and the second - 30 people. Results. Correlation analysis revealed a strong positive correlation between the CIRS-G comorbidity score 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). At the same time, the assessment of other parameters on the DASS-21 scale, such as depression and stress, did not show a reliably significant correlation effect. Also, the severity of cognitive deficits in this group did not depend on the number of comorbid diseases. There was also a positive correlation coefficient between comorbidity and asthenic syndrome as assessed by FAS - 0.699 (p=<0.001). A weaker negative correlation was seen between anxiety and CIRS-G - -0.474 (p=0.035). However, other DASS-21 scores, such as depression and stress, did not show a significant correlation effect. Also, the severity of cognitive deficits in this group did not depend on the number of comorbidities. All patients who received treatment with a combination of Xavron, Tivorel and Xylat noted an improvement in general well-being and a decrease in the severity of neurological symptoms. Changes in the severity of neurological deficit in 30 patients with Long-COVID (MOND) of the second group after the completion of the treatment course were significantly lower than in the first research group (P<0.05). Conclusions. The combination of Xavron, Tivorel and Xylat is pathogenetically primed and safe for the treatment of patients with long-covid. the use of this drug combination leads to reduction of asthenic syndrome, which, in turn, positively influences the reduction of cognitive manifestations of long-covid in the form of "brain fog".