Postcovid syndrome in residents of North-West Russia: clinical, laboratory and neuropsychiatric consequences
Authors: Belyakov N. A. , Rassokhin V. V. , Boeva E. V. , Knizhnikova A. A. , Norka A. A. , Khalezova N. B. , Vinogradova E. I. , Kushnir Ya. I. 
Published: November 2024

The aim. To analyze anamnestic data, clinical and laboratory parameters, and psychoneurological manifestations in patients in the post-COVID period.

Materials and methods. After the initial survey of 1,200 respondents who had suffered from a new coronavirus infection (COVID-19), a group of 170 patients was identiﬁed based on the presence of complaints about the state of somatic and mental health that have a temporary relationship with the SARS-CoV-2 disease. As part of the study, this group of patients underwent a comprehensive laboratory examination with an assessment of general clinical and biochemical parameters, inﬂammatory markers and the blood coagulation system. All patients were examined by an infectious disease specialist, a neurologist, a psychiatrist-narcologist and a medical psychologist. The main socio-demographic and clinical laboratory data in the post-COVID period, as well as neurological and psycho-emotional characteristics obtained from 130 participants in 2024, were assessed. In order to study cognitive and executive functions, psycho-emotional state, the following methods were used: Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS) and SCL-90 Symptomatic Questionnaire. In addition, each respondent was asked to determine the presence and severity of the main psychopathological, neurological, cognitive and general somatic symptoms using the «Not bothered-Weakly-Moderately-Extremely» scale specially developed for the study, which included up to 38 symptoms.

Results and discussion. The majority of the sample were women (80%). Over 2⁄3 of the respondents were of working age, with an average age of 38.2±11.3 years, and 65.3% had mild forms of COVID-19. Repeated cases of COVID-19 were associated with a high risk of blood saturation decrease to ≤93% (p<0.01), while severe COVID-19 was associated with the absence of vaccination (p<0.05). Ferritin levels below 30 μg/L were recorded in 34.1% of women and 9.15% of men, which may indicate a deﬁciency of iron stores in the body. Hypercholesterolemia was noted in 54.9% of cases, with average total cholesterol levels of 5.52±1.19mmol/L. The total number of NCI cases (2 or more) is associated with a decrease in the number of leukocytes, an increase in the number of platelets in the blood, the percentage of monocytes, a decrease in the level of total protein, an increase in the level of total cholesterol (p<0.05). Neurological symptoms are characterized by pronounced polymorphism, with 15.3% of respondents having exhaustion or absence of superﬁcial abdominal reﬂexes, 26.9% having mild cognitive impairment, and 7.7% having a signiﬁcant general decline in cognitive functions. 49.5% of respondents showed signs of anxiety, and 29.4% had depressive phenomena, expressed at the subclinical or clinical level. The severity of distress caused by sensations of bodily dysfunction of a somatic, painful and/or neuromuscular nature is characteristic, as well as mild hypochondriacal tendencies in a separate group of respondents.

Conclusion. Comparison of the results of the questionnaire and in-depth study showed that cognitive and psychoneurological disorders are widespread among patients of different age groups, regardless of the severity of the COVID-19. Given the mechanism of direct and indirect effects of SARS-CoV-2 on the brain, it is the symptoms of damage to the nervous system, including cognitive functions and the psychoemotional sphere, that largely determine the clinical symptoms of post-COVID disorders. The complexity and versatility of clinical and laboratory manifestations of post-COVID syndrome require the involvement of specialists of various proﬁles in working with patients, the need to develop protocols and recommendations for working with people with manifestations of post-COVID syndrome.