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Fatigue and cognitive impairment in post-COVID syndrome: possible treatment approaches

https://doi.org/10.14412/2074-2711-2021-4-88-93

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Abstract

Post-COVID syndrome can develop in all patients who have had COVID-19, regardless of the disease severity. Clinical manifestations postCOVID syndrome vary greatly, but the most common symptoms include fatigue, anxiety and depression disorders (ADDs), and cognitive impairment (CI).

Objective: to evaluate the efficacy and safety of Cholytilin (choline alfoscerate) and the combined drug MexiB 6 in patients with post-COVID syndrome and fatigue, ADDs, and CI.

Patients and methods. The study included 100 patients aged 22 to 71 years who have had COVID-19 5.4 months ago. Inclusion criterion: cognitive complaints, fatigue, and emotional disturbances. The evaluation included neurological exam, Montreal Cognitive Assessment Scale (MoCA), Frontal Assessment Battery (FAB), 10-words list task, Multidimensional Fatigue Inventory (MFI-20), Hospital Anxiety and Depression Scale (HADS). Study participants were divided into two groups. Patients who had ADDs (anxiety/depression level according to HADS ≥8 points; n=50) were prescribed with MexiB 6 (1 tablet three times per day). Patients with CI (mean MoCA score ≤25 points; n=50) were prescribed with Cholytilin (2 capsules (800 mg) in the morning and 1 capsule (400 mg) at lunchtime). The follow-up period was 60 days.

Results and discussion. According to MoCA scores, a decrease in cognition was observed in 58% of participants, while 28% did not notice CI earlier. ADD fere present in 51%, and fatigue — in 100% of patients. We observed a significant reduction in fatigue severity (from 62.42±7.18 to 52.32±16.36 points; p<0.05) in patients prescribed with MexiB 6. The majority of patients noted a significant increase in physical activity, decreased fatigue, improvement of attention and physical well-being, and increased workplace efficiency. We also found a significant decrease in ADDs severity: ADDs either regressed completely (in 42% of participants) or became subclinical (in 48%; р<0.001). CI severity also reduced according to mean МоСА (from 26.60±1.31 to 27.28±1.39 points; p<0.05) and FAB (from 16.98±1.06 to 17.20±0.90 points; p<0.05) scores. In a subgroup of patients with mild CI treated with Cholytilin mean МоСА (from 23.50±0.99 to 26.36±1.34; р<0.001) and FAB (from 16.02±0.91 to 16.96±0.99; р<0.001) scores significantly increased. Complete regression of CI was observed in 74% of participants (р<0.001). We also found a decrease in ADDs (р<0.001) and fatigue (mean MFI-20 scores decreased from 42.28±10.73 to 35.60±8.10; р<0.001) severity in all study participants.

Conclusion. Patients who have had COVID-19, regardless of the disease severity, have a high prevalence of fatigue, ADDs and CI, and MexiB 6 and Cholytilin have a potential in their treatment.

About the Authors

A. N. Bogolepova
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Federal Center of Brain and Neurotechnologies, FMBA of Russia
Russian Federation

Anna Nikolaevna Bogolepova.

1, Ostrovityanov St., Moscow 117997; 1, Ostrovityanov St., Build 10, Moscow 117997.


Competing Interests:

The conflict of interest has not affected the results of the investigation.



N. A. Osinovskaya
Federal Center of Brain and Neurotechnologies, FMBA of Russia
Russian Federation

1, Ostrovityanov St., Build 10, Moscow 117997.


Competing Interests:

The conflict of interest has not affected the results of the investigation.



E. A. Kovalenko
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Federal Center of Brain and Neurotechnologies, FMBA of Russia
Russian Federation

1, Ostrovityanov St., Moscow 117997; 1, Ostrovityanov St., Build 10, Moscow 117997.


Competing Interests:

The conflict of interest has not affected the results of the investigation.



E. V. Makhnovich
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia; Federal Center of Brain and Neurotechnologies, FMBA of Russia
Russian Federation

1, Ostrovityanov St., Moscow 117997; 1, Ostrovityanov St., Build 10, Moscow 117997.


Competing Interests:

The conflict of interest has not affected the results of the investigation.



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For citation:


Bogolepova A.N., Osinovskaya N.A., Kovalenko E.A., Makhnovich E.V. Fatigue and cognitive impairment in post-COVID syndrome: possible treatment approaches. Neurology, Neuropsychiatry, Psychosomatics. 2021;13(4):88-93. (In Russ.) https://doi.org/10.14412/2074-2711-2021-4-88-93

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)