Эмоциональные нарушения в структуре постковидного синдрома

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.

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