Actovegin use in patients with cognitive impairment after coronavirus infection (COVID-19)
https://doi.org/10.14412/2074-2711-2021-2-65-72
Abstract
Objective: to investigate the effectiveness of long-term oral administration of Actovegin in post-COVID patients with cognitive impairment (CI).
Patients and methods. 444 patients (142 men, 302 women) with COVID-19 and CI participated in the study. One-half of the included participants – 222 patients (70 men and 152 women) – were prescribed with actovegin 400 mg 3 times a day in addition to the baseline therapy; 222 patients (72 men and 150 women) were randomized to the control group. Cognitive functions were assessed with Montreal Cognitive Assessment (Montreal Cognitive Assessment test, МоСA test), fatigue – with Multidimensional Fatigue Inventory (MFI-20), emotional disturbances – with Spielberger-Hanin test.
Results and discussion. Post-COVID patients with CI in the Actovegin group after 60 days follow-up had higher mean MoCА scores (p<0.05), lower MFI (p<0.05), and Spielberger-Hanin test scores (p<0.05) compared to the control group.
Conclusion. Positive effect of Actovegin on the cognitive functions and emotional state of post-COVID patients with CI was observed.
About the Author
V. A. KutashovRussian Federation
10, Studencheskaya St., Voronezh 394036, Russia
References
1. Vremennyye metodicheskiye rekomendatsii «Profilaktika, diagnostika i lecheniye novoy koronavirusnoy infektsii (COVID-19). Versiya 10 (08.02.2021)» (utv. Minzdravom Rossii) [Interim guidelines «Prevention, diagnosis and treatment of new coronavirus infection (COVID-19). Version 10 (02/08/2021)» (approved by the Ministry of Health of Russia)]. Available from: https://static0.minzdrav.gov.ru/system/attachments/attaches/000/054/588/original/Временные_МР_COVID-19_%28v.10%29-08.02.2021_%281%29.pdf (In Russ.).
2. Kutashov VA, Dutova TI, Banin IN, et al. Damage to the nervous system in patients with a new coronavirus infection (clinical observation). Vselennaya mozga = Universe of the Brain. 2020;2(4(7)):23-8 (In Russ.).
3. Heneka MT, Golenbock D, Latz E, et al. Immediate and long-term consequences of COVID-19 infections for the development of neurological disease. Alzheimers Res Ther. 2020 Jun 4;12(1):69. doi: 10.1186/s13195-020-00640-3
4. Paterson RW, Brown RL, Benjamin L. The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings. Brain. 2020 Oct 1;143(10):3104-20. doi: 10.1093/brain/awaa240
5. Gusev EI, Martynov MYu, Boyko AN, et al. New coronavirus infection (COVID-19) and damage to the nervous system: mechanisms of neurological disorders, clinical manifestations, organization of neurological care. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = Journal of Neurology and Psychiatry. S.S. Korsakov. 2020;120(6):7-16. doi: 10.17116/jnevro20201200617 (In Russ.).
6. Mao L, Jin H, Wang M, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020 Jun 1;77(6):683-90. doi: 10.1001/jamaneurol.2020.1127
7. Hernandez-Fernandez F, Sandoval Valencia H, Barbella-Aponte RA, et al. Cerebrovascular disease in patients with COVID-19: neuroimaging, histological and clinical description. Brain. 2020 Oct 1;143(10):3089-103. doi: 10.1093/brain/awaa239
8. Lindlau A, Widmann CN, Putensen C, et al. Predictors of hippocampal atrophy in critically ill patients. Eur J Neurol. 2015 Feb;22(2):410-5. doi: 10.1111/ene.12443. Epub 2014 Apr 12.
9. Iwashyna TJ, Ely EW, Smith DM, Langa KM. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA. 2010 Oct 27;304(16):1787-94. doi: 10.1001/jama.2010.1553
10. Widmann CN, Heneka MT. Long-term cerebral consequences of sepsis. Lancet Neurol. 2014 Jun;13(6):630-6. doi: 10.1016/S1474-4422(14)70017-1
11. Girard T, Thompson J, Pandharipande P, et al. Clinical phenotypes of delirium during critical illness and severity of subsequent longterm cognitive impairment: a prospective cohort study. Lancet Respir Med. 2018 Mar;6(3):213-22. doi: 10.1016/S2213-2600(18)30062-6
12. Sasannejad C, Ely EW, Lahiri S. Long-term cognitive impairment after acute respiratory distress syndrome: a review of clinical impact and pathophysiological mechanisms. Crit Care. 2019 Nov 12;23(1):352. doi: 10.1186/s13054-019-2626-z
13. Konyaeva VV. Encephalopathy Associated with COVID-19: Experience of Clinical Observations in Practical Work of Neurologist. Lechebnoye delo = General Medicine. 2020;(3):43-6. doi: 10.24412/2071-5315-2020-12255 (In Russ.).
14. Fedorovich AA, Soboleva GN. Microcirculation in patients with arterial hypertension, coronary heart disease and cognitive impairment on treatment with Actovegin. Regionarnoye krovoobrashcheniye i mikrotsirkulyatsiya = Regional Blood Circulation and Microcirculation. 2015;14(3):40-51. doi: 10.24884/1682-6655-2015-14-3-40-51 (In Russ.).
15. Tanashyan MM, Shabalina AA, Lagoda OV, etc. Multimodal approach to the correction of neurological manifestations of chronic brain ischemia. Terapevticheskiy arkhiv = Therapeutic archive. 2018;(12):61-7. doi: 10.26442/00403660.2018.12.000010 (In Russ.).
16. Kovalchuk VV. The role of the new coronavirus infection (COVID-19) in the progression and development of cerebrovascular diseases. A competent choice of pathogenic treatment is the key to success in treatment and prevention. An expert’s view from the ‘red zone’. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(1):57-66. doi: 10.14412/2074- 2711-2021-1-57-66 (In Russ.).
17. Wade DT. Rehabilitation after COVID-19: an evidence-based approach. Clin Med (Lond). 2020 Jul;20(4):359-65. doi: 10.7861/clinmed.2020-0353. Epub 2020 Jun 9.
18. Boriskina LM. Actovegin in the treatment of patients with cognitive impairment in chronic cerebral ischemia. Nervno-myshechnyye bolezni. 2015;5(4):25-31. doi: 10.17650/2222-8721-2015-5-4-25-31 (In Russ.).
19. Mikhaylova NM, Selezneva ND, Kalyn YaB, et al. The effectiveness of Actovegin treatment in elderly patients with a syndrome of mild cognitive decline in vascular genesis. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. Spetsvypuski. 2013;113(7-2):69-76. Available from: https://www.mediasphera.ru/issues/zhurnal-nevrologii-i-psikhiatrii-im-s-s-korsakova-2/2013/7/031997-72982013728 (In Russ.).
20. Zakharov VV, Sosina VB. Possibilities of antihypoxants in the treatment of moderate cognitive impairments in patients with diabetes mellitus. Lechashchiy vrach. 2010;(3):87-91. Available from: https://www.elibrary.ru/item.asp?id=21546938 (In Russ.).
21. Kol'tsova EA. The use of Actovegin for the prevention of cognitive impairment after a stroke. Farmateka. 2018;5(358):66-70. Available from: https://www.elibrary.ru/item.asp?id=34998854 (In Russ.).
22. Guekht A, Skoog I, Edmundson S, et al. ARTEMIDA Trial (A Randomized Trial of Efficacy, 12 Months International DoubleBlind Actovegin): A Randomized Controlled Trial to Assess the Efficacy of Actovegin in Poststroke Cognitive Impairment. Stroke. 2017 May;48(5):1262-70. doi: 10.1161/STROKEAHA.116.014321
23. Kanowski S, Kinzler E, Lehmann E, et al. Confirmed clinical efficacy of Actovegin in elderly patients with organic brain syndrome. Pharmacopsychiatry. 1995 Jul;28(4):125-33. doi: 10.1055/s-2007-979604
24. Belopasov VV, Yashu Ya, Samoylova EM, Baklaushev VP. Damage to the nervous system in COVID-19. Klinicheskaya praktika. 2020;11(2):60-80. doi: 10.17816/clinpract34851 (In Russ.).
Review
For citations:
Kutashov V.A. Actovegin use in patients with cognitive impairment after coronavirus infection (COVID-19). Neurology, Neuropsychiatry, Psychosomatics. 2021;13(2):65-72. (In Russ.) https://doi.org/10.14412/2074-2711-2021-2-65-72