Astenic syndrome in a post-covid-19 patient (review and own experience)
Among the symptoms and syndromes that dominate the clinical picture of postcoid syndrome (POST-COVID-19), the signs of asthenia, increased fatigue, excessive exhaustion during normal daily activities, which form asthenic syndrome, are highlighted. For the treatment of postcoid asthenic syndrome, a combination of pathogenetically justified agents has been proposed: podaravone (Xavron), a mixture of L-arginine and L-carnitine (Tivorel), and a solution of xylitol (Xylate). 12 patients received the planned infusion program; the total duration of treatment was 14 days. Results: already on the 7th day of treatment, there was a significant decrease in the severity of weakness and fatigue of patients. At the end of the study, there was also an improvement in working capacity, a decrease in the severity of the feeling of “weakness” and an improvement in the ability to concentrate and attention. All patients tolerated the infusion program satisfactorily, no complications or side effects were observed during infusion therapy.
Key words: COVID-19, postcoid syndrome, asthenic syndrome, edaravone, Xavron, Tivorel, Xylat.
Literature:
- World Health Organization: Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). Geneva, WHO. 16-24 February, 2020. www.who.int/docs/default-source/coronavirus
- www.msdmanuals.com/professional/news/editorial/2020/09/23/20/17/post-covid-syndrome
- www.health.harvard.edu/blog/the-tragedy-of-the-post-covid-long-haulers-2020101521173
- www.jamanetwork.com/journals/ jamacardiology/fullarticle/2763524
- www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/10/C0840_pdf
- COVID-19 rapid guideline: managing the long-term effects of COVID-19. NICE guideline/ Published: 18 December 2020/ www.nice.org.uk/guidance/ng188
- Couzin-Frankel J. The long haul. Science. 2020 Aug 7;369(6504):614-617. doi: 10.1126/science.369.6504.614.
- Астенические расстройства в терапевтической практике. Руководство по диагностике и лечению. Под редакцией А.В. Шаброва, С.Л. Соловьевой. СПб, 2010, 380 с.
- Голубовська О.А. Постковідний синдром: патогенез та основні напрями реабілітації. Медична газета «Здоров’я України 21 сторіччя» №2 (495), 2021: 16-18.
- Varga Z., Flammer A.J., Steiger P. et al. Endothelial cell infection and endotheliitis in COVID-19. The Lancet. 2020; 395 (2): 1417-1418.
- Коваленко С.В. Досвід застосування методів синдромно-патогенетичної терапії при пневмонії, спричиненій COVID-19, в умовах пульмонологічного відділення. Медична газета «Здоров’я України 21 сторіччя» № 13-14 (481-482), 2020 р.
- Потенційні можливості лікування COVID-19: протидія надмірному запаленню, антиоксидантний вплив і цитопротекція. Медична газета «Здоров’я України 21 сторіччя», 2020, № 20 (489): 38-40.
- Reznik SE, Tiwari AK, Ashby CR Jr. Edaravone: A potential treatment for the COVID-19-induced inflammatory syndrome? Pharmacol Res. 2020 Oct;160:105055. doi: 10.1016/j.phrs.2020.105055.
- Saito Y, Fujii Y, Yashiro M, et al. Inhibitory Effects of Edaravone, a Free Radical Scavenger, on Cytokine-induced Hyperpermeability of Human Pulmonary Microvascular Endothelial Cells:A Comparison with Dexamethasone and Nitric Oxide Synthase Inhibitor. Acta Med Okayama. 2015;69(5):279-90. doi: 10.18926/AMO/53674.
- Watanabe K, Tanaka M, Yuki S, Hirai M, Yamamoto Y. How is edaravone effective against acute ischemic stroke and amyotrophic lateral sclerosis? J Clin Biochem Nutr. 2018 Jan;62(1):20-38. doi: 10.3164/jcbn.17-62.
- Hashimoto S., Sanui M., Egi M. et al. The clinical practice guideline for the management of ARDS in Japan. Journal of Intensive Care. 2017; 5: 50. doi: 10.1186/s40560-017-0222-3.
- Поліщук М.Є., Галушко О.А., Гуменюк М.І., Тріщинська М.А. Інфузійна терапія в неврології і нейрохірургії. К.: Книга-плюс, 2020. 304 с.
- Zhang W, Zhao Y, Zhang F, et al. The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): The Perspectives of clinical immunologists from China. Clin Immunol. 2020 May;214:108393. doi: 10.1016/j.clim.2020.108393.
- Галушко О.А. Особливості виникнення та перебігу електролітних порушень в гострий період інсульту у хворих на цукровий діабет. Медицина неотложных состояний, 2017, №1(80): 87-92.
