Features of the course of postcovid syndrome, its effect on quality of life and some indicators of hemostasis and catecholamine metabolism
Authors:   Central Research Institute of Epidemiology, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, Russian Federation, Omarova Kh.G. , Marzhokhova A.R. ,   Central Research Institute of Epidemiology, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, Russian Federation, Muzyka A.D. ,   Central Research Institute of Epidemiology, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, Russian Federation, Shapieva N.T. ,   Central Research Institute of Epidemiology, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, Russian Federation, Provotorova M.P. ,   Central Research Institute of Epidemiology, Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, Moscow, Russian Federation
Published: September 2024

The novel COVID-19 coronavirus infection is known to be characterized by recovery in most cases, but long-term sequelae persist in 10–20% of survivors. To date, the pathophysiologic characterization and clinical significance of the impact of SARSCoV-2 on endocrine organs, as well as the impact of the associated endocrine dysfunction on the prognosis of COVID-19 survivors, have not been fully explored and are not sufficiently reported in the literature. It has been suggested that catecholamines, especially in excessive concentrations, cause dysregulation of physiologic cascades, which may be closely related to unfavorable outcomes in COVID-19. The objective of the work was to determine the diagnostic significance of hemostasis and catecholamine metabolism indices in COVID-19 patients with and without post-COVID-19 syndrome, their correlation with the reported cognitive impairments. Patients and methods. 90 patients – 14 males and 76 females – who underwent COVID-19 without consequences in the form of post-COVID-19 syndrome (PCS) were examined, and the main group included patients with PCS. Patients underwent laboratory examination: coagulogram, determination of P-selectin level and daily urine examination with determination of catecholamines, catecholamine and serotonin metabolites (adrenaline, noradrenaline, dopamine, homovanillic acid, vanillylmindalic acid, 5-hydroxyindoleacetic acid). The main group consisted of 60 patients with PCS (9 (15%) men, 51 (85%) women, and the control group consisted of 30 patients without PCS (5 (16.7%) men, 25 (83.3%) women. Patients in the control group more often carried COVID-19 asymptomatically or in a non-serious form without lung damage, while patients in the main group with lung damage in 21.7% of cases. Results. The duration of PCS ranged from 4 to 36 months at the time of examination, with a median of 24 months. Its manifestation was maximal in 43.3%. Decreased quality of life associated with COVID-19 was noted by 53.3% of patients in the main group. Complaints of cognitive impairment (CI) were the most frequent in the structure of PCS in 53 patients (88.3%). The duration of CI was less than a year in 21.7%, one to two years – 15%, two and more years – 55%. Evaluation of CI severity on a five-point scale: 1 point – 10%, 2 point – 20%, 3 point – 35%, 4 point – 18,3%, 5 point – 8,3%. The predominant CI patterns were impaired concentration 78.3%, (24 [12; 35.5] months), memory 71.7%, (24 [10.5; 35.5] months), lethargy 53.3%, (12 [6; 24] months), brain fog 51.7%, (12 [7; 24] months). In the main group, 30% of patients and 10% of patients in the control group (p = 0.034) had CI according to MoCA scale (less than 26 scores). Patients in the main group with CI according to MoCA scale presented problems for 2 or more years in 55.6% of cases, less than a year – 22.2%, from a year to 2 years – in 11.1%. The presence of at least 1 symptom was noted by 88.3% of respondents. According to the results of laboratory methods, the median level of adrenaline in daily urine was higher in the main group (p = 0.025). No statistically significant difference was found in the study of hemostasis parameters between the two groups. Key words: hemostasis, catecholamines, quality of life, post-coital syndrome, scales