medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2024-148medsovet-8227Research ArticleНЕВРОЛОГИЯNEUROLOGYЭмоциональные нарушения в структуре постковидного синдромаEmotional disturbances in postcovid syndrome structurehttps://orcid.org/0000-0002-1478-6580МихееваА. Г.MikheevaA. G.

Михеева Анна Геннадьевна, врач-невролог, аспирант кафедры неврологии с клиникой Института медицинского образования, лаборантисследователь, Научно-исследовательская лаборатория новой коронавирусной инфекции и постковидного синдрома, Центр персонализированной медицины

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Anna G. Mikheeva, Neurologist, Postgraduate Student of the Department of Neurology with the Clinic of the Institute of Medical Education, Research Assistant, Research Laboratory of New Coronavirus Infection and Post-Covid Syndrome, Center for Personalized Medicine

2, Akkuratov St., St Petersburg, 197341

amikheevag@mail.ruhttps://orcid.org/0000-0002-0175-3085ТопузоваМ. П.TopuzovaM. P.

Топузова Мария Петровна, к.м.н., доцент кафедры неврологии с клиникой Института медицинского образования, старший научный сотрудник, Научно-исследовательская лаборатория новой коронавирусной инфекции и постковидного синдрома, Центр персонализированной медицины

197341, Санкт-Петербург, ул. Аккуратова, д. 2

 

Mariya P. Topuzova, Cand. Sci. (Med.), Associate Professor of the Department of Neurology with the Clinic of the Institute of Medical Education, Senior Researcher, Research Laboratory of New Coronavirus Infection and Post-Covid Syndrome, Center for Personalized Medicine

2, Akkuratov St., St Petersburg, 197341

Topuzova_MP@almazovcentre.ruhttps://orcid.org/0009-0002-1540-4801МихееваМ. Г.MikheevaM. G.

Михеева Мария Геннадьевна, студент

214019, Смоленск, ул. Крупской, д. 28

 

Maria G. Mikheeva, Student

28, Krupskaya St., Smolensk, 214019

mg.mikheeva@yandex.ruhttps://orcid.org/0000-0002-4441-1165АлексееваТ. М.AlekseevaT. M.

Алексеева Татьяна Михайловна, д.м.н., заведующая кафедрой неврологии с клиникой Института медицинского образования

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Tatiana M. Alekseeva, Dr. Sci. (Med.), Head of the Department of Neurology with the Clinic of the Institute of Medical Education

2, Akkuratov St., St Petersburg, 197341

 

Alekseeva_TM@almazovcentre.ruhttps://orcid.org/0000-0002-1547-0123КароноваТ. Л.KaronovaT. L.

Каронова Татьяна Леонидовна, д.м.н., заведующая научно-исследовательской лабораторией новой коронавирусной инфекции и постковидного синдрома, Центр персонализированной медицины, главный научный сотрудник научно-исследовательской лаборатории клинической эндокринологии Института эндокринологии, профессор кафедры эндокринологии Института медицинского образования

197341, Санкт-Петербург, ул. Аккуратова, д. 2

Tatiana L. Karonova, Dr. Sci. (Med.), Head of the Research Laboratory of New Coronavirus Infection and Post-Covid Syndrome, Center for Personalized Medicine, Chief Researcher of the Research Laboratory of Clinical Endocrinology of the Institute of Endocrinology, Professor of the Department of Endocrinology of the Institute of Medical Education

2, Akkuratov St., St Petersburg, 197341

Karonova_TL@almazovcentre.ruНациональный медицинский исследовательский центр имени В.А. АлмазоваРоссияAlmazov National Medical Research CenterRussian FederationСмоленский государственный медицинский университетРоссияSmolensk State Medical UniversityRussian Federation20241005202405108116Copyright © Михеева А.Г., Топузова М.П., Михеева М.Г., Алексеева Т.М., Каронова Т.Л., 20242024Михеева А.Г., Топузова М.П., Михеева М.Г., Алексеева Т.М., Каронова Т.Л.Mikheeva A.G., Topuzova M.P., Mikheeva M.G., Alekseeva T.M., Karonova T.L.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8227

В статье рассмотрены эмоциональные нарушения, развивающиеся в постковидном периоде, особенности их течения и факторы риска развития, а также нарушения сна после коронавирусной инфекции (COVID-19). Нервная система (НС) – одна из главных мишеней вируса SARS-CoV-2, что подтверждается гипо-/аносмией, которая развивается у большинства пациентов в остром периоде COVID-19, причем у части больных она является первым симптомом. В настоящее время основными прямыми путями воздействия коронавируса на НС считаются гематогенный и нейрональный. Кроме того, существует иммуноопосредованное влияние на НС за счет цитокинового шторма. У большинства пациентов после острого периода коронавирусной инфекции развивается постковидный синдром. В его структуре значимое место занимают неврологические проявления, в частности эмоциональные нарушения. Депрессия, тревожность, патологическая утомляемость, а также нарушения сна беспокоят пациентов чаще всего. В динамике выраженность большинства симптомов у определенной части пациентов снижается, однако, согласно исследованиям ряда авторов, постковидные проявления сохраняются или усугубляются в течение длительного времени. К факторам риска развития постковидных эмоциональных нарушений в настоящее время чаще всего относят женский пол и психиатрическую коморбидность. Несмотря на то что пандемия официально считается завершенной, а острый период COVID-19 в настоящее время протекает гораздо легче, чем в 2020–2021 гг., к врачам-терапевтам и неврологам по-прежнему обращаются пациенты с вновь возникшими эмоциональными нарушениями в постковидном периоде, что подчеркивает сохраняющуюся актуальность данной проблемы. Стоит отметить, что эмоциональные нарушения в постковидном периоде могут развиваться у пациентов всех возрастных групп, снижая качество их жизни и работоспособность. Информированность населения, ранняя диагностика и начало лечения данных нарушений позволит избежать глобальных последствий.

In this article emotional disturbances developing in the postcovid period, their features and risk factors are reviewed, as well as sleep disorders after coronavirus infection (COVID-19). The nervous system (NS) is one of the SARS-CoV-2 main targets, which is confirmed by hypo-/anosmia, which develops in most patients during the acute period of COVID-19, and in some patients it is the first symptom. Currently, the main direct routes of coronavirus impact on the NS are considered to be hematogenous and neuronal. In addition, there is an immune-mediated effect on the NS due to the cytokine storm. After an acute period of coronavirus infection postcovoid syndrome often develops. Neurological manifestations, in particular emotional disorders, occupy a significant place in its structure. Depression, anxiety, fatigue, as well as sleep disorders bother patients most often. In dynamics, the severity of most symptoms in a certain part of patients decreases, however, according to some studies, postcovid manifestations persist or worsen for a long time. Currently, female gender and psychiatric comorbidity are most often considered risk factors for the development of postcovid emotional disorders. Despite the fact that the pandemic is officially considered over, and the acute period of COVID-19 is currently much easier than in 2020–2021, internists and neurologists are still treated by patients with newly emerged emotional disorders in the postcovid period, which underlines the continuing relevance of this problem. It is worth noting that emotional disorders in the postcovid period can develop in patients of all age groups, reducing their quality of life and workability. Public awareness, early diagnosis and initiation of treatment of these disorders will help to avoid global consequences.

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The authors declare that there are no conflicts of interest present.