medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2024-21-47-52medalphabet-3955Research ArticleСтатьиПсихоневрологические нарушения в структуре постковидного синдромаPsychoneurological disorders in the stage of post-COVID syndromehttps://orcid.org/0009-0001-4791-8674СолдатенкоА. А.SoldatenkoA. A.

Солдатенко Александр Александрович - врач-психиатр.

Симферополь

Alexander A. Soldatenko – psychiatrist.

Simferopol

ГуменюкЛ. Н.GumenyukL. N.

Гуменюк Леся Николаевна - д. м. н., проф. кафедры психиатрии, наркологии, психотерапии с курсом общей и медицинской психологии.

Симферополь

Lesya N. Gumenyuk - DM Sci (habil.), professor at Dept of Psychiatry, Narcology, Psychotherapy with a Course of General and Medical Psychology.

Simferopol

lesya_gymenyuk@mail.ruhttps://orcid.org/0000-0003-1505-4506БобрикЮ. В.BobrikYu. V.

Бобрик Юрий Валерьевич - д. м. н., проф. кафедры лечебной физкультуры и спортивной медицины и физиотерапии с курсом физического воспитания.

Симферополь

Yuri V. Bobrik - DM Sci (habil.), professor at Dept of Physical Therapy and Sports Medicine and Physiotherapy with a Course of Physical Education.

Simferopol

Медицинский центр «Авиценна»РоссияAvicenna Medical CenterRussian FederationОрдена Трудового Красного Знамени Медицинский институт имени С.И. Георгиевского (структурное подразделение ФГАОУ ВО «Крымский федеральный университет имени В.И. Вернадского)РоссияOrder of the Red Banner of Labor of the Medical Institute named after S.I. Georgievsky (structural unit V.I. Vernadsky Crimean Federal University)Russian Federation202408112024021Неврология и психиатрия (3)4752Copyright © Солдатенко А.А., Гуменюк Л.Н., Бобрик Ю.В., 20242024Солдатенко А.А., Гуменюк Л.Н., Бобрик Ю.В.Soldatenko A.A., Gumenyuk L.N., Bobrik Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/3955Цель исследования

Цель исследования. Обобщение и систематизация представлений о патофизиологических механизмах развития астенического синдрома на фоне перенесенного COVID-19.

Материалы и методы

Материалы и методы. В работе проанализированы научные статьи и монографии, посвященные этиопатогенезу постковидного астенического синдрома (ПКАС). Поиск осуществлялся по ключевым словам «COVID-19», «постковидный синдром», «психоневрологические нарушения», «астенический синдром» с использованием баз данных PubMed, Medline, eLibrary.ru.

Результаты и обсуждение

Результаты и обсуждение. Систематизированы представления о клинической структуре ПКАС, представлены механизмы проникновения вируса SARS-CoV-2 в нервную систему, освещены современные взгляды в отношении молекулярных механизмов развития неврологической симптоматики у реконвалесцентов COVID-19. Описаны ключевые патогенетические звенья ПКАС, включая иммунные девиации, ассоциированные с нарушением цитокинового баланса, реакции окислительного и нитрозативного стресса с последующей активацией анаэробных метаболических путей в мозговой и мышечной тканях; нейрометаболические изменения, сопровождающиеся дисфункцией серотонинергической, дофаминергической, норадренергической и ГАМК-ергической систем.

Заключение

Заключение. Анализ данных мировой литературы, а также собственный клинический опыт позволяют заключить, что психоневрологические нарушения, ассоциированные с инфекцией COVID-19, носят многогранный комплексный характер и сопровождаются весьма вариабельной симптоматикой. При этом существующая фрагментарность знаний в отношении патомеханизмов психоневрологических нарушений на фоне COVID-19 диктует настоятельную необходимость продолжения дальнейших исследований в этой области.

Аim

Аim. Generalization and systematization of ideas about the pathophysiological mechanisms of asthenic syndrome development against the background of COVID-19.

Materials and methods

Materials and methods. The work analyzed scientific articles and monographs devoted to the etiopathogenesis of post-COVID asthenic syndrome (PCAS). The search was carried out by the keywords «COVID-19», «post-COVID syndrome», «psychoneurological disorders», «asthenic syndrome» using the PubMed, Medline, eLibrary.ru databases.

Results and discussion

Results and discussion. The ideas about the clinical structure of PCAS are systematized, the mechanisms of penetration of the SARS-CoV-2 virus into the nervous system are presented, modern views on the molecular mechanisms of the development of neurological symptoms in COVID-19 convalescents are highlighted. The key pathogenetic links of PCAS are described, including immune deviations associated with cytokine imbalance, oxidative and nitrosative stress reactions with subsequent activation of anaerobic metabolic pathways in brain and muscle tissues; neurometabolic changes accompanied by dysfunction of the serotonergic, dopaminergic, noradrenergic and GABAergic systems.

Conclusion

Conclusion. Analysis of world literature data, as well as our own clinical experience, allows us to conclude that psychoneurological disorders associated with COVID-19 infection are multifaceted and complex and are accompanied by highly variable symptoms. At the same time, the existing fragmentary knowledge regarding the pathomechanisms of psychoneurological disorders against the background of COVID-19 dictates an urgent need to continue further research in this area.

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