Mild post-COVID syndrome in young patients

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Abstract

Background. Many COVID-19 survivors suffer from post-COVID syndrome, which significantly worsens the quality of life. Its presentation is quite diverse, with cognitive disorders being of particular importance. Liver injury due to the direct virus action and the treatment of the new coronavirus infection can persist for a long time during the recovery period and lead to hyperammonemia, which can cause cognitive disorders, including minimal hepatic encephalopathy.

Aim. To study cognitive disorders in post-COVID syndrome and the possibility of their treatment with L-ornithine-L-aspartate.

Materials and methods. The study included 30 students from 18 to 24 years old who had COVID-19 and decreased attention, memory impairment, and other cognitive disorders inherent in hepatic encephalopathy of latent (grade 0) or mild (grade 1) severity, without pronounced impairment of intelligence, memory, speech, and learning ability. Hyperammonemia, elevated alanine aminotransferase, aspartate aminotransferase, and ã-glutamyl transpeptidase, signs of hepatic encephalopathy according to psychometric tests, were reported in young people. All patients in the study were treated with L-ornithine-L-aspartate to correct the ammonia blood level and improve signs of hepatic encephalopathy and the general condition.

Results and conclusion. An improvement in the objective findings, liver enzymes, a decrease in ammonia level, and an improvement in testing results for changes in cognitive functions were reported.

About the authors

Gleb S. Ivchenko

North-Caucasus Federal University

Author for correspondence.
Email: ivchenko1980@mail.ru
ORCID iD: 0000-0002-8012-282X

канд. мед. наук, и.о. зав. каф. внутренних болезней медико-биологического фак-та

Russian Federation, Stavropol

Natela N. Lobzhanidze

North-Caucasus Federal University

Email: ivchenko1980@mail.ru
ORCID iD: 0009-0006-1841-2574

ассистент каф. внутренних болезней медико-биологического фак-та

Russian Federation, Stavropol

Daria S. Rusina

North-Caucasus Federal University

Email: ivchenko1980@mail.ru
ORCID iD: 0009-0009-0306-8864

ассистент каф. внутренних болезней медико-биологического фак-та

Russian Federation, Stavropol

Evgeniya V. Denisova

North-Caucasus Federal University

Email: ivchenko1980@mail.ru
ORCID iD: 0000-0003-3149-4376

канд. биол. наук, доц., доц. каф. биохимии, молекулярной биологии и медицины медико-биологического фак-та

Russian Federation, Stavropol

Anna A. Ivchenko

North-Caucasus Federal University

Email: ivchenko1980@mail.ru
ORCID iD: 0000-0002-7859-4342

канд. мед. наук, и.о. зав. каф. терапевтической, хирургической и ортопедической стоматологии медико-биологического фак-та

Russian Federation, Stavropol

References

  1. Alkodaymi MS, Omrani OA, Fawzy NA, et al. Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis. Clin Microbiol Infect. 2022;28(5):657-66. doi: 10.1016/j.cmi.2022.01.014
  2. Crivelli L, Palmer K, Calandri I, et al. Changes in cognitive functioning after COVID-19: A systematic review and meta-analysis. Alzheimers Dement. 2022;18(5):1047-66. doi: 10.1002/alz.12644
  3. Захаров Д.В., Буряк Ю.В. Постковидные когнитивные расстройства. Современный взгляд на проблему, патогенез и терапию. Обозрение психиатрии и медицинской психологии имени В.М. Бехтерева. 2021;55(4):97-105 [Zakharov DV, Buriak YV. The Post-COVID-19 cognitive impairment. A modern view of the problem, pathogenesis and treatment. VM Bekhterev Review of Psychiatry and Medical Psychology. 2021;55(4):97-105 (in Russian)]. doi: 10.31363/2313-7053-2021-55-4-97-105
  4. Алексеенко Ю.В. Когнитивные нарушения после перенесенной коронавирусной инфекции. Рецепт. 2022;25(4):496-502 [Alekseenko YuV. Cognitive Impairment after COVID-19. Prescription. 2022;25(4):496-502 (in Russian)]. doi: 10.34883/PI.2022.25.4.009
  5. Камчатнов П.Р., Соловьева Э.Ю., Хасанова Д.Р., Фатеева В.В. Астенические и когнитивные нарушения у пациентов, перенесших COVID-19. РМЖ. Медицинское обозрение. 2021;5(10):636-41 [Kamchatnov PR, Solov'eva EYu, Khasanova DR, Fateeva VV. Asthenic and cognitive disorders in patients having had COVID-19. Russian Medical Inquiry. 2021;5(10):636-41 (in Russian)]. doi: 10.32364/2587-6821-2021-5-10-636-641
  6. Танерова Н.Г. Анализ течения постковидного синдрома на основе данных анкетирования пациентов. Вестник молодого ученого. 2022;11(2):58-60 [Tanerova NG. Analysis of post-COVID syndrome course based on patient questionnaire data. Journal of Young Scientists.2022;11(2):58-60 (in Russian)].
  7. Кабыш С.С., Карпенкова А.Д., Прокопенко С.В. Когнитивные нарушения и COVID-19. Сибирское медицинское обозрение. 2022;2:40-8 [Kabysh SS, Karpenkova AD, Prokopenko SV. Cognitive impairments and COVID-19. Siberian Medical Review. 2022;2:40-8 (in Russian)]. doi: 10.20333/25000136-2022-2-40-48
  8. Житкова Ю.В., Хасанова Д.Р. Опыт лечения постковидных когнитивных нарушений (клиническое наблюдение). Медицинский совет. 2022;(11):102-7 [Zhitkova YuV, Khasanova DR. Treatment experience of post-COVID cognitive impairment (clinical observation). Meditsinskiy sovet=Medical Council. 2022;(11):102-7 (in Russian)]. doi: 10.21518/2079-701X-2022-16-11-102-107
  9. Лазебник Л.Б., Тарасова Л.В., Комарова Е.А., и др. Изменение концентрации аммиака и других биохимических показателей у пациентов с новой коронавирусной инфекцией. Экспериментальная и клиническая гастроэнтерология. 2021;188(4):76-83 [Lazebnik LB, Tarasova LV, Komarova EA, et al. Change in concentration of ammonia and other biochemical indicators in patients with new coronaviral infection. Experimental and Clinical Gastroenterology. 2021;188(4):76-83 (in Russian)]. doi: 10.31146/1682-8658-ecg-188-4-76-83
  10. Liao X, Li D, Ma Z, et al. 12-Month Post-Discharge Liver Function Test Abnormalities Among Patients With COVID-19: A Single-Center Prospective Cohort Study. Front Cell Infect Microbiol. 2022;12:864933. doi: 10.3389/fcimb.2022.864933
  11. Bobermin LD, Quincozes-Santos A. COVID-19 and hyperammonemia: Potential interplay between liver and brain dysfunctions. Brain Behav Immun Health. 2021;14:100257. doi: 10.1016/j.bbih.2021.100257
  12. Плотникова Е.Ю., Синькова М.Н., Исаков Л.К. Астения и утомление при гипераммониемии: этиопатогенез и методы коррекции. Медицинский совет. 2021;(21-1):95-104 [Plotnikova EYu, Sinkova MN, Isakov LK. Asthenia and fatigue in hyperammonemia: etiopathogenesis and methods of correction. Meditsinskiy sovet=Medical Council. 2021;(21-1):95-104 (in Russian)]. doi: 10.21518/2079-701X-2021-21-1-95-104
  13. Подымова С.Д. Новые подходы к патогенезу, клинике, лечению печеночной энцефалопатии. Терапевтический архив. 2021;93(2):236-42 [Podymova SD. New approaches to the pathogenesis, clinic, and treatment of hepatic encephalopathy. Terapevticheskii Arkhiv (Ter. Arkh.). 2021;93(2):236-42 (in Russian)]. doi: 10.26442/00403660.2021.02.200613
  14. Кизова Е.А., Потехина Ю.П. Влияние терапии препаратом l-орнитин-l-аспартат на уровень гипераммониемии и результаты теста связывания чисел у пациентов с неалкогольной жировой болезнью печени. Экспериментальная и клиническая гастроэнтерология. 2019;169(9):80-4 [Kizova EA, Potekhina YuP. Effect of l-ornithine-l-aspartate therapy on the hyperammonemia level and results of the number connection test of patients suffering from nonalcoholic fatty liver disease. Experimental and Clinical Gastroenterology. 2019;169(9):80-4 (in Russian)]. doi: 10.31146/1682-8658-ecg-169-9-80-84
  15. Долгушина А.И., Кузнецова А.С., Картошкина Ю.В., Селянина А.А. Усталость и уровень аммиака капиллярной крови у студентов медицинского университета. Экспериментальная и клиническая гастроэнтерология. 2020;176(4):31-8 [Dolgushina AI, Kuznetsova AS, Kartoshkina YuV, Selyanina AA. Fatigue and ammonia levels of capillary blood in medical students. Experimental and Clinical Gastroenterology. 2020;176(4):31-8 (in Russian)]. doi: 10.31146/1682-8658-ecg-176-4-31-38
  16. Подымова С.Д., Винницкая Е.В., Хайменова Т.Ю. Печеночная энцефалопатия: современные аспекты диагностики и лечения. Экспериментальная и клиническая гастроэнтерология. 2021;191(7):90-8 [Podymova SD, Vinnitskaya EV, Haimenova TYu. Hepatic encephalopathy: modern aspects of diagnostics and treatment. Experimental and Clinical Gastroenterology. 2021;191(7):90-8 (in Russian)]. doi: 10.31146/1682-8658-ecg-191-7-90-98

Supplementary files

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1. JATS XML
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2. Fig. 1. Possible relationship between liver injury and astrocyte injury in COVID-19. Colored circles represent NH3, inflammatory mediators, and acute phase proteins; the red arrow indicates the activation of astrocytes driven by these substances.

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3. Fig. 2. Statistical data on NH3 level (mean value).

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4. Fig. 3. Statistical data on -glutamyl transpeptidase level (a) and the number connection test (b) – mean values.

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5. Fig. 4. The results of the statistical analysis of the mean values of the MoCA test (a) and the number arrangement test (b) – mean values.

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6. Fig. 5. Statistical data on the levels of aspartate transaminase (a) and alanine transaminase (b) – mean values.

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