Postcoid syndrome

Main article: Coronavirus COVID-19

2024: Bovgialuronidase azoximer increases exercise tolerance in patients with long-term pulmonary effects of COVID-19

Petrovax announced positive results from the Long-CoV-III-21 study, a randomized, double-blind, placebo-controlled study of the efficacy and safety of azoximer bovgialuronidase in adult patients with postcovid pulmonary sequelae. Bovgialuronidase azoximer, available under the trade name Longidase, is a conjugated polymer hyaluronidase with an increased half-life. Study drug and placebo were administered for 71 days and the follow-up period lasted up to 180 days. The company announced this on December 18, 2024. Read more here.

2023: Russian scientists have identified human genes associated with neurological complications of COVID-19

Scientists from the subordinate Ministry of Education and Science of Russia Peter the Great St. Petersburg Polytechnic University, together with colleagues from Ufa, have identified human genes associated with neurological complications after the coronavirus (COVID-19). A scientific article on the results of the study was published in the journal MDPI.

Russian experts have identified genetic markers that allow in the future to create clinical tests for the diagnosis and stratification of patients with COVID-19.

Illustration of the work of genes

The goal of our study was more focused, we were looking for genetic variants related to how the transferred disease affects the neurological functions of a person, such as, for example, memory, sleep disorder, tendency to depression and others, "said Alexander Kanapin, candidate of biological sciences, leading researcher at the Center for Computational Biology of SPBPU, head of the laboratory of neurocognitive genomics at UUNiT.

During the first three waves of the pandemic, scientists selected 336 students aged 18 to 25 years. All the necessary information was collected about the participants: gender, ethnic origin, history of SARS-CoV-2 infection, dates of infection and clinical symptoms accompanying the disease. All cases, according to scientists, were with a mild or moderate course of the disease - without shortness of breath, with a low temperature and a runny nose. However, the study subjects had neurological symptoms. Severe headache, memory and sleep problems, loss of smell, taste disorder, anxiety and depression manifested themselves during the disease or after recovery and persisted for about a year.

Scientists have begun to search for genetic markers associated with the severe course of covid and with manifestations of problems in the neurological and cognitive sphere. The results, in particular, confirmed the previously shown association of one of the enzymes (encoded by the FURIN gene) interacting with the spike protein of the coronavirus with a higher susceptibility to COVID-19 infection.

In addition, markers associated with one of the genes involved in the regulation of inflammatory processes (NR1H2) were found to be associated with the manifestation of neurological symptoms in mild to moderate disease. In turn, genes associated with metabolic processes in nervous tissue and secretion of anti-inflammatory cytokines (SLC6A20, FYCO1) contain genetic variants associated with long-term neurological complications after COVID-19.^[1]

2022

Ultrasound images show liver damage from COVID-19

At the end of November 2022, it became known that coronavirus (COVID-19) infection is associated with an increase in liver stiffness, which is a sign of possible long-term damage to the organ. The relevant findings of the study were made public at the annual meeting of the Radiological Society of North America ( RSNA).

Liver stiffness is a marker of its damage, such as inflammation or fibrosis. Fibrosis is the accumulation of scar tissue in the liver. Over time, healthy liver tissue decreases and the liver can no longer function normally. Progressive fibrosis can lead to liver cancer and liver failure.

On Ultrasound pictures showed long-term liver damage in COVID-19 patients

In a retrospective study, scientists compared the liver stiffness of patients with a history of COVID-19 infection with two control groups. All patients underwent shear wave ultrasound elastography between 2019 and 2022 at Massachusetts General Hospital. Shear wave elastography is a specialized technique that uses sound waves to measure tissue stiffness.

Patients were assigned to one of three groups depending on when they underwent elastography and whether they tested positive for COVID-19. The group with a positive result for COVID-19 included 31 patients in whom the result of the PCR test for COVID-19 was positive at least 12 weeks before elastography. The pandemic control group consisted of a random sample of 50 patients who underwent elastography during the COVID-19 pandemic and had a history of only negative PCR test results for COVID-19. The pre-pandemic control group consisted of a random sample of 50 patients who underwent elastography before the COVID-19 pandemic.

The median age was 53.1 years for COVID-positive patients, 55.2 years for the pandemic control group, and 58.2 years for the pre-pandemic control group. Of the total cohort, 67 were women. In the group of COVID-positive patients, elastographic examination was carried out on average 44 weeks after a positive PCR test result.

After controlling for age, sex, and time period, statistical analysis of elastography results showed that COVID-positive patients had significantly higher liver stiffness than control patients. In COVID-positive patients, the median stiffness in living condition was higher (7.68 kPa) than in control patients (5.99 kPa).

Unexpectedly, it turned out that in the control group before the pandemic, the median stiffness was also higher (7.01) than in the control group of the pandemic. The reason for this result is not yet clear, but it is assumed that this is the result of a change in the scheme of referring patients for examination during a pandemic. In addition, it was noted that patients referred for elastography before the pandemic were older than patients referred after the start of the pandemic.^[2]

Myocarditis has become the most common manifestation of postcoid syndrome in children

On August 22, 2022, a study was published according to which myocarditis was the most commonly diagnosed disease associated with COVID-19 (PASC).

Among more than 650 thousand people under the age of 21, tested for antigen or RT-PCR, incidence of at least one systemic, the syndromic or drug-induced sign of PASC was 41.9% among children who tested positive compared to 38.2% among children who tested negative 28 to 179 days after initial testing. reported Suchitra Rao, Bachelor of Medicine and Bachelor of Surgery, of the University of Colorado School of Medicine and Colorado Children's Hospital in Aurora, and colleagues.

Myocarditis has become the most common manifestation of postcoid syndrome in children

The most common PASC-related disease was myocarditis (aHR 3.10, 95% CI 1.94-4.96), while loss of taste or smell was the most common symptom (adjusted HR 1.96, 95% CI 1.16-3.32) and cough and cold medications were the most commonly prescribed medications (aHR 1.52, 95% CI 1.18-1.96), they noted in JAMA Pediatrics.

For this study, Rao and colleagues used electronic medical record data from nine U.S. children's hospitals on 659,286 patients who had positive analysis results from March 2020 to October 2021, with at least one previous case in the 3 years prior to the analysis. The mean age was 8.1 years, 52.8% of patients were male.

They examined 151 clinically predicted signs of PASC and made adjustments for place of residence, age, sex, race and ethnicity, obesity, testing site (emergency department, inpatient, outpatient clinic or outpatient trial facility), treatment in the intensive care unit between 7 days and 13 days after entering the sample, and the complexity of care.

Of the total number of patients, 9.1% tested positive for the virus test and 90.9% tested negative. The majority of patients were tested in outpatient (50.3%) or routine settings (24.6%).

In addition to the most common signs of PASC, patients with a positive test also had a higher incidence of acute respiratory distress syndrome (aHR 2.96, 95% CI 1.54-5.67), myositis (aHR 2.59, 95% CI 1.37-4. 89), dental or gum disease (aHR 1.48, 95% CI 1.36-1.60), other or undetermined heart disease (aHR 1.47, 95% CI 1.17-1.84), and fluid and electrolyte disorders (aHR 1.45, 95% CI 1.32-1.58).

They also had higher rates of loss of smell (aHR 1.85. 95% CI 1.20-2.86), psychiatric treatment (aHR 1.62. 95% CI 1.46-1.80), hair loss (aHR 1.58. 95% CI 1.24-2.01), chest pain (aHR 1.52. 95% CI 1.38-1.68), abnormal liver enzymes (aHR 1.50. 95% CI 1.27-1.77), anxiety symptoms (aHR 1. 29. 95% CI 1.08-1.55), skin rashes (aHR 1.26. 95% CI 1.15-1.38), fatigue and malaise (aHR 1.24. 95% CI 1.13-1.35), fever and chills (aHR 1.22. 95% CI 1.16-1.28), cardiorespiratory signs and symptoms (aHR 1.20. 95% CI 1.15-1.26) and diarrhea (aHR 1.18. 95% CI 1.09-1.29).^[3]

COVID-19 significantly increases the risks of stroke, Alzheimer's and Parkinson's disease

At the end of June 2022, a study conducted in Denmark showed that outpatients with COVID-19 had an increased risk of diagnosing Parkinson's disease, Alzheimer's disease, stroke and cerebral hemorrhage compared to patients with a negative COVID-19 result. Most neurological disorders after coronavirus infection were no more common than after other respiratory infections, according to a study published in the journal Frontiers in Neurology.

The study used electronic medical records covering approximately 50% of Denmark's population, which is estimated at 3 million people. The work analyzed patients who tested positive for coronavirus infection (COVID-19) and bacterial pneumonia in hospitals from February 2020 to November 2021, and also considered patients with influenza for the corresponding pre-pandemic period from February 2018 to November 2019.

COVID-19 significantly increases the risks of stroke, Alzheimer's and Parkinson's disease

The study showed that 43,375 people tested positive for COVID-19, and 876,356 people tested negative for this disease out of a total of 919,731 participants. Of the 43,375 patients who tested positive for COVID-19, 35,362 were outpatients and 8,013 were hospitalized.

The researchers found that outpatients who tested positive for COVID-19 had 3.5 times the risk of being diagnosed with Alzheimer's disease, 2.6 times the risk of Parkinson's disease, 2.7 times the risk of ischemic stroke and 4.8 times the risk of intracerebral hemorrhage, that is, cerebral hemorrhage. But when the researchers compared the relative risk of neurological diseases with other respiratory diseases, such as influenza, it turned out that the increased risk of most neurological diseases in COVID-19-positive patients is not higher than in patients with other respiratory diseases, but with one exception, according to scientists. Researchers found that the risk of ischemic stroke increased among hospitalized patients with COVID-19, compared with inpatients with influenza.

More than two years after the start of the COVID-19 pandemic, the exact nature and evolution of the impact of COVID-19 on neurological disorders remained unexplored. Although the risk of ischemic stroke was increased in COVID-19 compared to influenza, it is encouraging that most neurological disorders are not more common after COVID-19 than after influenza or bacterial pneumonia. These results will help deepen our understanding of the long-term effects of COVID-19 on the body and the role that infections play in the development of neurodegenerative diseases and stroke, said lead author Dr. Pardis Zarifkar.

The study was limited because it did not take into account potential confounding variables such as socioeconomic factors, lifestyle, prior comorbidities, and length of hospitalization. Although the study included a large population, it was able to consider only a subset of the absolute number of individuals tested in the country. Due to the fact that only tests conducted in hospital institutions in Denmark, as well as registered in the country's electronic health records system, were used in the study.^[4]

Scientists have confirmed the presence of anomalies in the brain of those who have had coronavirus

On February 28, 2022, it became known that scientists at NUST MISIS"," MSU named after M.V., together with experts Sberbank , used the developed neurointerface on the basis of to electroencephalography assess the characteristics of electric the brain activity of people who had recovered. COVID-19 The revealed features of the brain can be interpreted as a manifestation of possible neurological consequences. Researchers have shown statistically significant signal differences brain in people who have suffered and have not undergone COVID-19.

Scientists have confirmed the presence of anomalies in the brains of those who have had coronavirus. Photo: azned.net.

According to the company, loss of smell, blurred consciousness, difficulties in concentration, disorders, dream inhibition and a number of other serious neurological symptoms are often found in people who have had coronavirus SARS-CoV-2 (COVID-19). As of February 2022, it is known that the infection is accompanied by inflammatory and degenerative reactions in the brain, which can explain the above symptoms.

A group of scientists from NUST MISIS, the Faculty of Mechanics and Mathematics of Moscow State University named after M.V. Lomonosov and the team for the development of a neurointerface for the control of experimental machine learning systems of the SberDevices department analyzed the features of the electrical activity of the brain after an infection. The tests were attended by 32 people who had had a coronavirus infection, and 40 people who had not previously encountered the virus. The study participants were given a speech task: for three seconds, words were shown on the screen that had to be read to themselves. The electrical activity of the brain during the experiment was analyzed by EEG.

Recording data was carried out using a neurointerface developed by the team. As a result, the processed data array includes characteristics of the frequency, time and spatial ranges. Then they were analyzed neural network using a classifier, the task of which was, on the basis of the data obtained, to attribute a person to a group of people who had or did not have coronavirus. According to the results of the study, abnormal patterns of electrical activity visible on the EEG were found in almost 80% of subjects who had previously had the COVID-19 coronavirus.

According to the authors of the study, the data obtained confirm the hypothesis that people who have undergone coronavirus infection have neurological disorders that can be identified by the EEG method, said Alexandra Bernadotte, author of the development, mathematician and doctor, Ph.D., associate professor of the Department of Engineering Cybernetics at NUST MISiS, Timlid Team of Neurointerfaces, Executive Director of the Department of Experimental Machine Learning Systems SberDevices. The neurointerface itself is a serious achievement, and if we talk about the prospects for introduction into real medical practice, it should be noted that it is fully compatible with existing medical equipment, and it can be used, among other things, to control the rehabilitation of patients who have undergone coronavirus infection.

In the future, scientists note, a non-invasive neurointerface for recognizing internal speech based on EEG can be used to assess and diagnose neurological consequences in people who have undergone COVID-19.

2021

Smell disorder may develop after recovering from COVID-19

Those who have had the COVID-19 coronavirus and have recovered may develop a sense of smell disorder - parosmia, which cannot be cured with medicines. Ilya Akinfiev, an infectious disease doctor, told the agency about this in December 2021 Ura.ru.

Albeit rarely, but I have patients who complain not about the lack of smell, but even worse - about pathological odors, that is, they do not feel pleasant odors, only putrid, - he noted.

According to him, everything that was tried from medical treatment did not help patients. He noted that parosmia passes by itself over time, but each has different ways. On average, most patients have smell disorders in two months, but there are a number of patients who have no positive dynamics for more than six months.

Smell disorder may develop after recovering from COVID-19

With parosmia, a person can feel a mixture of unpleasant odors. Most often, the smell of fried food is more difficult to tolerate. In most cases, of the data that are available today, such a reaction manifests itself on protein food - meat, dairy products, eggs, vegetables - potatoes, onions and red peppers.

Former chief infectious disease specialist of Moscow Nikolai Malyshev suggested that by the end of 2021, not all the consequences of the transferred coronavirus have become open for study.

With covid, the wall of the vessels is affected, and they are in all organs, tissues, respectively, all organs and tissues are affected. Some more, others less depending on which body it is: healthy, sick. Therefore, we see many different symptoms from all internal organs and skin, - said the agency's interlocutor.

Earlier, the therapist, nutritionist Nadezhda Chernyshova warned Russians about problems with the perception of alcohol after COVID-19. She noted that usually with parosmia, products "change" the smell and taste in the patient's perception, one of these groups is alcoholic beverages.^[5]

FMBA: Coronavirus accelerates aging of the body

In mid-December 2021, the Federal Medical and Biological Agency (FMBA) reported on the impact of coronavirus (COVID-19) infection on aging processes.

COVID-19 provokes and accelerates processes similar to restructuring during aging, - said the head of the FMBA Veronika Skvortsova at a general meeting of the Russian Academy of Sciences.

She explained that coronavirus infection provokes the processes of chronic inflammation of various organs and systems of the body - similar changes occur in all people and increase with age.

FMBA: COVID-19 accelerates the aging of the body

Veronika Skvortsova added that new approaches are needed to the formation of restorative treatment in people who have had COVID-19. The FMBA is conducting relevant studies by December 2021.

Earlier, the chief freelance geriatrician of the Ministry of Health Olga Tkacheva said that COVID-19 is capable of triggering premature aging processes in the body. She explained that the coronavirus is called "aging disease," and noted that in older citizens it goes into a long post-covid syndrome and can speed up the aging process.

Premature aging of the body of patients who have suffered COVID-19 even in a mild form, among the likely consequences mentioned last year and Professor of the School of Systems Biology at George Mason University Ancha Baranova. She referred to the results of the work of a group of doctors, during which those who underwent the disease were examined in a moderate and mild form. According to Baranova, even among those who had been ill in a weak form, 70% had pathology of some internal organs - mainly the liver and pancreas. Usually, such diagnoses are made to patients of older generations, but these symptoms were noticed in those who had been ill at the age of about 40 years.^[6]

Cases of "black mold" after COVID-19 recorded in Russia

In November 2021, it became known about a new consequence of the coronavirus (COVID-19) infection. In Russia, cases of the so-called "black mold" (mucormycosis) have been recorded, which deprives vision, wrote Pavel Popov, a radiologist, candidate of medical sciences and head of the radiation diagnostics department at the Ilyinsky hospital in the Moscow region, on his Facebook page.

He described the case of one of the patients. According to Popov, the disease arose two months after the coronavirus.

Cases of "black mold" after COVID-19 recorded in Russia

At first, a small painful lump appeared in the left half of the nose, stopped seeing the left eye, watery eyes occurred. Tingling and unpleasant sensations began in the forehead and cheekbones. The pathological process was noticed after CT and MRI of the paranasal sinuses.

As proof, the doctor attached the pictures. He named the uncontrolled use of antibiotics and corticosteroids as the cause of mucormycosis.

Recently, more and more often they write about rhinorbitocerebral mucormycosis as a disease that has a close relationship with a coronavirus infection. The main version of pathogenesis is the uncontrolled use of antibiotics and corticosteroids leads to immunosuppression, and, as a result, infection with opportunistic fungi. In India, this disease - "black mushroom" - takes on the character of a national disaster. Will there be a similar situation in other countries?, - said the radiologist.

In the comments under Popov's Facebook message, a doctor from Samara wrote that he had more than ten such cases.

Everyone with diabetes, "he said.

The first cases of "black mold" in Russia became known in the summer of 2021. Then only two patients with mucormycosis were reported. According to Alexander Gorelov, deputy director for scientific work of the Central Research Institute of Epidemiology of Rospotrebnadzor, the threat of the spread of the disease was minimal.^[7]

Murashko warned of severe damage to the heart and lungs of those who have recovered from COVID-19

On October 12, 2021, the head of the Ministry of Health of the Russian Federation, Mikhail Murashko, warned of a serious defeat of the heart and lungs in those who suffered a coronavirus (COVID-19) infection. According to the minister, those who have been ill may also have endocrine damage and skin problems.

Murashko at the Presidium of the Coordination Council under the Government for the fight against coronavirus noted that serious pathologies in COVID-19 patients are detected during in-depth medical examination. The head of the Russian Ministry of Health added that young age is not insurance against the severe course of coronavirus, since the infection has changed. According to Mikhail Murashko, by October 12, 2021, of all those infected with coronavirus, 12-13% are children.

Mikhail Murashko warned of severe damage to the heart and lungs of those who have had COVID-19

Earlier in 2021, scientists at Moscow State University found out that tachycardia is the new post-covid syndrome. The researchers noted that previously all research in the field of coronavirus focused on epidemiology, risk factors for people and treatment strategies. However, there is growing evidence that COVID-19 can cause serious cardiovascular disorders.

This new condition is classified as postcoid syndrome, but its clinical characteristics and treatment strategy remain largely unknown. Some of the most frequent complaints from patients who have undergone COVID-19 are heart palpitations and heart outages, the study says.

According to the deputy director for scientific work of the Central Research Institute of Epidemiology of Rospotrebnadzor, Corresponding Member of the Russian Academy of Sciences Alexander Gorelov, vaccination helps to defeat post-covid syndrome. At the same time, the tolerance of vaccination in patients after coronavirus is the same as in completely healthy people.^[8]

WHO has officially defined post-covid syndrome

In early October 2021, the World Health Organization (WHO) gave an official definition of post-covid syndrome. It is observed in 20% of those who have had the COVID-19 coronavirus.

The WHO said that post-covid syndrome manifests itself in people with a suspected coronavirus or a confirmed history of infection, as a rule, three months after the start of COVID-19 with symptoms that last at least two months and cannot be explained by an alternative diagnosis.

WHO has officially defined post-covid syndrome and named its manifestations

Among the main symptoms of postoid syndrome, experts named:

• increased fatigue (from 28.3% to 67.8%);

• shortness of breath (32.2% to 74.3%);

• cough (7.1% to 42.6%);

• sleep disturbance (17.7% to 56.5%);

• cognitive impairment (18% to 21.6%);

• loss of smell (12% to 14.6%);

• loss of taste (9% to 10%);

• sore throat (3.2% to 9%).

WHO provided the definition after a survey of 460 WHO researchers, patients, experts and staff in different countries of the world, including Russia. The study participant needed to answer 45 questions anonymously. Consensus on a particular item of the questionnaire was achieved if 70% of participants set from 7 to 9 points on the Likert scale, which evaluates the degree of agreement with the approval.

Doctors noted that these symptoms may appear after recovery from COVID-19 or persist from the moment of illness. Symptoms of postcoid syndrome may change and reappear after some time, worsening and weakening from time to time. According to WHO experts, at least 10-20% of patients suffer from "long-term covid."

The WHO emphasizes that the definition of post-covid syndrome will allow it to be accurately diagnosed, separating it from other diseases and ailments, which, in turn, will help those who have had it to cope with its manifestations faster.^[9]

Ministry of Health: after COVID-19, a high risk of life threat remains for six months

At the end of September 2021, the Ministry of Health of the Russian Federation warned of the dangerous consequences of infection with the coronavirus COVID-19 six months after the illness.

After such a disease, a high risk of threat to life and health remains for six months, - said the head of the Ministry of Health Mikhail Murashko.

According to him, the population is reluctant to undergo medical examination, despite the fact that the state provides such an opportunity. As part of such services, specialists can identify possible health risks and prescribe preventive therapy against certain diseases. Recently ill COVID-19 (from two to six months ago) have a priority right to undergo such a procedure.

The Ministry of Health warned that after COVID-19, a high risk of life threat remains for six months

Earlier, Murashko said that after the coronavirus there are complications associated with the formation of blood clots, damage to the nervous and cardiovascular system.

Also, the head of the Ministry of Health said that patients who have suffered coronavirus may have a "long covid" for another 6-9 months and longer.

At the same time, symptoms that persist for such a long time can include various body systems. Patients note neurological, including cognitive disorders, memory problems, increased fatigue, various manifestations from the cardiovascular system, respiratory organs, musculoskeletal system, - Murashko noted at a conference call with the regions at the end of September 2021.

Oksana Drapkina, chief freelance specialist of the Ministry of Health in therapy and general practice, urged to be vaccinated against coronavirus and not wait for immunity acquired after an illness. According to her, "the cost of such immunity can be complications, up to deaths, or the consequences, which are called" long covid^[10]

Risk of acute kidney injury within 6 months of illness

According to a study published in August 2021, survivors Covid-19 are at increased risk of acute injury. kidneys

"It's a really huge problem and it will literally define our lives for the next decade or more."

Non-hospitalized patients who have undergone Covid have a 23% increased risk of acute kidney injury within six months - a condition that prevents waste and toxins from being removed from the blood. The pandemic could boost demand for dialysis and organ transplantation.

About a third of people three to four months after COVID-19 have post-covid syndrome

In mid-August 2021 Rospotrebnadzor , they named the share of patients with postcoid syndrome - the consequences of coronavirus infection. COVID-19

Because of him, [post-covid syndrome], about a third of people, three to four months after the disease, cannot fully take care of themselves, perform some everyday business, "RIA Novosti quotes Khadizhat Omarova, head of the clinical research department of the Central Research Institute of Epidemiology of Rospotrebnadzor.

Rospotrebnadzor: About a third of people three to four months after COVID-19 have post-covid syndrome

According to her, post-covid syndrome causes a significant decrease in the quality of life. After receiving a negative PCR test, the symptoms can persist for several weeks, and sometimes months. After a mild form of coronavirus, patients recover in about two weeks, with moderate and severe - in three to six weeks. On average, postcoid syndrome passes within six months, but in some it lasts longer.

Khadizhat Omarova noted that there is no connection between the severity of the disease and the occurrence of postcoid syndrome, even patients who have had a mild illness may face complications, but children cope with them better.

Rehabilitation after covid is needed by everyone. And it is important to start it as early as possible in order to prevent the development of fibrous tissue in the lungs. This recommendation is especially relevant for people with extensive lung damage and who were on mechanical ventilation, she stressed.

The concept of "post-covid syndrome" includes from 20 to 60 symptoms. Most patients experience weakness, heaviness in the chest, feeling of incomplete inhalation. Many are tormented by head, joint and muscle pain. Some develop sleep disturbance, depression, worsening attention, memory and reaction rate, and increased sweating. Some have numbness in their limbs.^[11]

COVID-19 patients revealed a decrease in intelligence

At the end of July 2021, it became known that people who have recovered from COVID-19 tend to show significantly lower intelligence test results compared to those who have not contracted the virus, according to a new study published in The Lancet EClinicalMedicine. The results of the study indicate that the SARS-CoV-2 virus causing COVID-19 can cause a significant decrease in cognitive abilities, especially in people with a more severe form of the disease.

Coincidentally, the pandemic escalated in the UK in the middle of the time when I collected data on cognitive abilities and mental health on a very large scale as part of the BBC2 Horizon collaboration (this is a global British intelligence test). The test consisted of a set of tasks designed to measure different aspects of cognitive abilities that were developed for application, both in citizen science and in clinical research. Several of my colleagues contacted me in parallel to point out that this provides an opportunity to collect important data on how the pandemic and COVID-19 disease affect people's mental health and cognitive abilities. I thought about the same and wanted to help than I could, so I expanded the study to include information about COVID-19 disease and the impact of the pandemic on everyday life in general, "said lead researcher Adam Hampshire, assistant professor of computational, cognitive and clinical neuroimaging at Imperial College London.

In patients with COVID-19, a decrease in intelligence was found

For their study, Hampshire and his team analyzed data from 81,337 participants who took an intelligence test between January and December 2020. Of the entire sample, 12,689 people reported that they had suffered COVID-19 with varying degrees of respiratory severity.

After checking factors such as age, gender, mother tongue, education level and other variables, the researchers found that people infected with the COVID-19 virus tended to perform worse with an intelligence test compared to those who were not sick. The greatest deficit was observed in tasks requiring reasoning, planning and problem solving.

Previous studies have also shown that most people who survive COVID-19 suffer from neuropsychiatric and cognitive complications.

We need to be careful, since the virus can affect cognitive activity and we do not fully understand how and why. In the meantime, don't risk it in vain and get vaccinated, "Hampshire said.

The level of cognitive impairment was also associated with the severity of the disease, with the greatest deficits observed in those hospitalized with severe form and lying on a ventilator. The observed deficit in COVID-19 patients was equal to a 7-point decrease in IQ. These deficits were even larger than the deficits seen in people who had previously suffered a stroke.

I think it is fair to say that those of us who analyzed such data are somewhat nervous about the decision to let the pandemic take its toll in the UK, "Hampshire said.[12][13]

Rospotrebnadzor announced the onset of postcoid syndrome a few months after recovery

On July 9, 2021, Rospotrebnadzor announced the onset of post-covid (COVID-19) syndrome a few months after recovery.

Postcoid syndrome develops between three and 24 weeks after an acute phase or discharge from hospital. The most common symptoms of the syndrome are noted after four weeks, - said Antonina Ploskireva, deputy director for clinical work of the FBUN Central Research Institute of Epidemiology of Rospotrebnadzor, whose words are quoted by RIA Novosti.

Rospotrebnadzor reported the onset of postcoid syndrome a few months after recovery

According to Ploskireva, she refers to data from a systematic review published in June 2021. She added that even those people who suffered coronavirus asymptomatic may develop post-covid syndrome in a month. Coronavirus can lead to the formation of irreversible changes in the lungs, heart attack and, to stroke after which the patient can become disabled, Antonina Ploskireva reported earlier.

According to the memo on the prevention of complications after COVID-19, which was published by the Ministry of Health of the Russian Federation, about 20-30% of those who have recovered from postcoid syndrome face thrombosis. Another 31.7% of patients have shortness of breath, 13.5% have cough, and 12.7% complain of chest pain and tachycardia. The ministry recommends that those who have recovered undergo an in-depth medical examination to prevent the syndrome. It became available in Russia from July 1, 2021.

Earlier, a cardiologist of the highest category, Yulia Lotsmanova, Moscow said on the air of the radio station "Talking" that clinical tests and urine allow to detect signs of the consequences of the infection blood in time. Among the key indicators in the diagnosis of prolonged COVID-19, she named the levels of blood clotting, electrolytes and troponin, thyroid hormones, as well as vitamin D.^[14]

The Ministry of Health of the Russian Federation named the most frequent complications in those who have had COVID-19

In July 2021, the Ministry of Health of the Russian Federation issued a memo in which it reported on the consequences of the coronavirus COVID-19 after recovery. According to the ministry, 20-30% of those who have had an infection may have thrombosis. In addition, the following serious complications can be observed within the framework of postcoid syndrome:

• shortness of breath - in 31.7% of those who have recovered;
• cough - 13.5%;
• complaints of chest pain and tachycardia - 12.7%.

Shortness of breath, cough, chest pain: the most frequent complications in those who have had coronavirus

These symptoms may primarily indicate a violation in the activities of the cardiovascular and respiratory systems. There are other symptoms, the manifestation of which occurs to a lesser extent, however, they can cause adverse consequences in a person who has undergone a new coronavirus infection, according to the document of the Ministry of Health.

The ministry defines post-covid syndrome as "persistent symptoms and/or delayed or long-term complications after four weeks from the onset of symptoms."

In order to prevent the development of complications after coronavirus, it is necessary to timely identify any changes in the body. For this, an in-depth medical examination program was launched in Russia on July 1. Citizens can pass it in the clinic at the place of attachment, you need to have a passport and a policy with you.

In July 2021, Denis Protsenko, chief physician of the city clinical hospital No. 40 in Kommunarka, said that due to the heat established in the capital, the risk of thrombosis in patients presenting with coronavirus is growing. Older patients face this more often than others.

On July 13, 2021, Liubov Drozdova, the chief freelance specialist in medical prevention of the Russian Ministry of Health, said that people who have had coronavirus are often subjected to thrombosis, complain of fatigue and shortness of breath.^[15]

Numbness of limbs and hearing problems

In June 2021 Rospotrebnadzor , they reported a rare symptom in those who had had coronavirus. COVID-19 According to Central Research Institute of Epidemiology  Natalya Pshenichnaya, Deputy Director for Clinical and Analytical Work of Rospotrebnadzor, we are talking about numbness of the limbs or a decrease in their sensitivity in post-covid syndrome, less than 8% of patients complain about this.

The appearance of such a symptom Pshenichnaya was associated with a decrease in the nutrition of nerve fibers during the acute period of development of coronavirus infection. Concomitant diseases in patients can also contribute to the emergence of such an effect - for example, diabetes mellitus, the specialist did not rule out.

Numbness of the legs and ear congestion. Rospotrebnadzor spoke about the problems of COVID-19 patients

Yevgeny Timakov, chief physician of the Leader-Medicine medical center, agrees that cases of numbness of the limbs after a coronavirus infection may be associated with a violation of the blood supply to nerve fibers. The virus disrupts the blood supply in the limbs, causes microthrombs, he noted.

Also, the deputy director for clinical and analytical work of the Central Research Institute of Epidemiology of Rospotrebnadzor said that about 18-23% of patients with coronavirus suffer from ear congestion, which leads to hearing loss. This is a reversible process and can be cured - in about 1.5-2% of those who have recovered, the residual phenomena of this symptom appear within a few weeks after recovery. Pshenichnaya reported that cases of acute sensorineural hearing loss are observed in isolated cases.

It is believed that hypoxia of the auditory center in the event of a severe course of the disease, as well as the use of certain drugs, may contribute to the development of this condition. This pathology can be easily missed if the patient is in the intensive care unit for a long time, the epidemiologist emphasized.

Earlier, Doctor of Medical Sciences, immunologist Vladislav Zhemchugov explained that COVID-19 affects the most vulnerable organs in the human body, including hearing and vision problems may become a result of the infection.^[16]

Vascular damage

According to the data obtained, COVID-19 can cause pronounced inflammatory processes in the body, damaging the internal walls of blood vessels and disrupting microcirculation in them. As a result, the cardiovascular system is seriously affected, diseases such as myocarditis, pericarditis, thromboembolism, heart attacks and strokes can develop. In addition, the following are "under attack":

• organs of vision,
• liver and biliary tract,
• digestive organs,
• ENTs,
• skin and hair, and
• immune,
• nervous,
• endocrine and
• reproductive systems.

In this regard, patients who have undergone the disease may need the help of a pulmonologist, cardiologist, neurologist, otolaryngologist, ophthalmologist and other narrow-profile doctors.

Diagnostic programs are recommended for all persons who have undergone COVID-19. But in particular, this is important for patients over the age of 60, with chronic diseases of the digestive organs, cardiovascular system, respiration, endocrine glands. And also in cases where shortness of breath, difficulty breathing, cough, prolonged nasal congestion, heart pain, blood pressure change, general weakness, rapid fatigue, sleep and mood disorders persist in the post-covid period.

As you know, the lungs are most often the target of the disease: 30-40% of patients with COVID-19 develop pneumonia and pneumonitis, which require long-term follow-up (for 6-12 months), as well as a comprehensive rehabilitation program.

The rehabilitation program includes consultations with specialized specialists (pulmonologist and physiotherapist), hardware and laboratory diagnostic examinations, as well as a course of physiotherapeutic procedures. Rehabilitation measures allow you to optimize lung function, increase local immunity, improve sputum diversion, as well as prevent the development of sclerotic changes in lung tissue.

According to doctors, postcoid syndrome is a fairly wide range of conditions and disorders with psychophysiological consequences. Therefore, in some cases, simply cure the infection is not enough - it is no less important to identify possible complications after the disease and undergo rehabilitation under the attention of qualified doctors.

Problems with breathing, nervous system and head. Results of a large-scale research on influence of COVID-19 on had are published.

COVID-19 changes blood cells of those who have been ill

In early June 2021, researchers from the Max Planck Center for Physics and Medicine and FAU published the results of a study according to which COVID-19 infection causes significant changes in the size and severity of red blood cells and white blood cells that can persist for several months. These findings may explain why some patients have a long history of symptoms after first contracting the virus.

We were able to register significant and prolonged changes in cells both during the acute phase of the infection and after it, - said one of the authors of the study. To analyze the blood of those who had recovered, scientists used their own method, which they called real-time cell deformability cytometry (RT-DC).

COVID-19 is able to change the blood cells of those who have recovered

During the tests, the researchers passed blood cells through a narrow channel and captured images of deformed red blood cells and white blood cells using a high-speed camera. Special software determined the type of cells, their size and degree of deformation. Using this method, scientists analyzed up to 1000 blood cells per second and overall estimated more than four million blood cells in 17 patients in the acute phase of COVID-19 infection, in 14 people who recovered from the infection, and in 24 healthy people.

The results showed that the size and plasticity of red blood cells differed significantly between sick people and healthy volunteers. Thus, the coronavirus damages these blood cells, which may explain the increased risk of thrombosis in a given infection, as well as a decrease in blood oxygenation. The researchers also found a significant decrease in white blood cell stiffness in patients with COVID-19, which may be a sign of a pronounced immune response. The deformity of neutrophils turned out to be so persistent that it persisted even seven months after the acute infection.^[17]

The head of the FMBA reported an increase in the number of complications in those who have had COVID-19

At the end of May 2021, the head of the Federal Medical and Biological Agency (FMBA) of Russia Veronika Skvortsova spoke about the growing number of cases of complications in people who have had coronavirus (COVID-19) infection.

Currently, there is data on an increase in the frequency of complications in people who have undergone coronavirus infection, from thrombosis and cardiovascular pathology to mental disorders, the Russian News Agency quoted Skvortsova as saying.

She also stated the need to prevent and treat non-communicable diseases that can lead to a more severe course of COVID-19: diabetes, obesity, cardiovascular ailments, chronic pulmonary pathology and others.

The head of the FMBA Veronika Skvortsova reported an increase in the number of complications in COVID-19 patients - thrombosis, cardiovascular pathologies and mental disorders

A group of scientists from Oxford University previously reported on the possible risk of developing mental disorders in patients who have recovered from coronavirus infection. Experts analyzed more than 70 million electronic medical records in the United States, where there were data on 62 thousand people who had recovered from COVID-19. Doctors came to the conclusion that mental disorders identified within 14-90 days after the diagnosis of "coronavirus infection of a new type" occurred in 18.1% of patients, and in 5.8% of the study participants they were identified for the first time. The most common scientists called anxiety, post-traumatic stress disorder, depression, insomnia, memory disorders.

According to the Russian doctor, allergist-immunologist Vladimir Bolibok, the COVID-19 coronavirus increases the risk of death of patients with "harmless" symptoms, because the infection exacerbates everything that is "unfavorable" that is in the human body. According to the Ministry of Health, the coronavirus gives twice as many complications as seasonal flu and other similar respiratory diseases.^[18]

Turkey buys Russian Tianox devices to treat complications after coronavirus

On May 17, 2021, it became known about the decision of Turkish medical centers to purchase the Russian Tianox apparatus, designed to treat complications after the coronavirus COVID-19. This is the development of the Russian Federal Nuclear Center - the All-Russian Research Institute of Experimental Physics (RFNC-VNIIEF). Read more here.

Risk of breathing, nervous system and head problems in COVID-19 survivors

At the end of April 2021, scientists from Washington University in St. Louis published the results of the largest comprehensive study on the long-term impact of COVID-19. According to these data, COVID-19 patients, including in a mild form, increased the risk of death within six months after diagnosis. The researchers also presented a general overview of the long-term complications of COVID-19, including problems with the respiratory and nervous systems.

The study involved more than 87,000 patients with COVID-19. The researchers showed that after the initial infection (a month after infection), the risk of death over the next six months increased by almost 60% compared to the usual figures. After six months, excess mortality among all COVID-19 survivors was estimated at eight people per 1,000 patients. Among patients initially hospitalized with COVID-19, excess mortality was 29 cases per 1000 patients.

COVID-19 patients have increased risk of death within six months after diagnosis

Researchers have confirmed that COVID-19 can affect almost all organ systems. From the respiratory system, incessant cough, shortness of breath and low oxygen saturation in the blood were isolated, from the nervous system - stroke, headaches, problems with memory and taste and smell disorders, from mental health - anxiety, depression, sleep problems and substance abuse. In addition, the researchers highlighted a number of metabolic, cardiovascular, gastrointestinal and other problems.

According to the analysis, the quality of life of patients who have undergone COVID-19 turned out to be much worse than that of patients who have undergone influenza. The risk of death in COVID-19 survivors was 50% higher than in influenza survivors, and in addition, they had a higher risk of long-term health problems.^[19]

The risk of thromboembolic complications in COVID-19 is higher than in SARS-CoV-2 vaccination

On April 15, 2021, information appeared that scientists from the University of Oxford published a study comparing the risks of thromboembolic complications as a result of COVID-19 disease and similar risks associated with vaccination against the SARS-CoV-2 virus.

Illustration: Oxford University scientific paper

According to the results of the study:

• the risk of developing solid brain shell sinus thrombosis (CCTMO) in patients with COVID-19 is 95 times higher than in the general population;
• the risk of developing CCTMO with immunization with mRNA vaccines is 10 times lower than in patients with COVID-19;
• the risk of developing TSTMO during immunization with AstraZeneca vaccine is 8 times lower than in patients with COVID-19.

Illustrations: Oxford University scientific paper

AstraZenek emphasized: "We continue to study the possible causes of thromboembolic complications when using the vaccine. The published study provides us with additional information to understand the possible mechanism of occurrence of this rare adverse event. "

Risk of massive mental disorders in COVID-19 survivors

More than 80% of those who have had coronavirus noted "fog in the head," which can be a symptom of brain hypoxia. In March 2021, Associate Professor of the Department of Aging Diseases of the Russian Gerontological Scientific and Clinical Center of the Russian National Research Medical University named after Pirogov Elen Mkhitaryan.

According to the doctor, more than 62 thousand cases of COVID-19 were analyzed in the United States and compared the likelihood of mental complications. In two studies, it was found that coronavirus infection is 2 times more likely to lead to mental illness than influenza virus and other infections. COVID-19 refers to the so-called neurotropic coronaviruses. In addition to respiratory disorders, they can lead to diseases of the nervous system, since lung damage disrupts the supply of oxygen to the brain.

"The most sensitive organ to hypoxia is the hippocampus in the brain. This structure is very vulnerable, any decrease in blood flow is reflected in the hippocampus. Coronavirus leads to an increase in tau protein deposits, as a result of which the process of development of Alzheimer's disease is launched, "said Elen Mkhitaryan.

According to the doctor, an online survey of patients conducted by the Russian Gerontological Research and Clinical Center (RGNCC) revealed anxiety in almost 30% of respondents and depression in about 17% of people aged 18 to 47 years. The pandemic provoked a deterioration in the mental and mental health of the population, says Elen Mkhitaryan. As the survey showed, the main causes of anxiety are concern about financial stability, violation of plans and habitual lifestyle, anxiety for the health of elderly relatives.

Older patients are particularly at risk of cognitive impairment as a result of infection or termination of active social life. According to Elen Mkhitaryan, scientists at the Russian National Research Center are inclined to include COVID-19 in the list of risk factors for dementia, a severe and extremely common disease.

"There are 12 risk factors for dementia, among them alcohol consumption, air pollution, obesity, hearing loss, depression, hypertension, smoking, hypodynamics, diabetes mellitus. 40% of dementia risk factors can be modified, 60% are not modifiable, "said Elen Mkhitaryan.

The risk of dementia is reduced by 5 factors of social relations - marriage, support for family members, contact with friends, participation in community groups, and the presence of paid work. Active social life in old age, according to doctors, reduces the risk of cognitive impairment by 46%.

Notes