Psychocognitive dysfunction in comorbid patients in the post-COVID period

Abstract

Introduction. Currently, psychopathological symptoms are noted in a third of patients with COVID-19, according to published systematic reviews. Aim. To study psychocognitive function in comorbid patients depending on the coronavirus infection caused by SARS-CoV-2.Material and methods. The observational analytical cohort study included 223 patients with AF and comorbidity (ischemic heart disease, arterial hypertension, obesity, type 2 diabetes mellitus) aged 60–74 years, who were divided into 2 groups: 1st –  123 patients without COVID –19 and 2nd – 110 patients with a history of COVID-19 and the presence of PCS. The group of patients with a history of COVID-19 was retrospectively divided into 2 groups depending on the intake of sulodexide; patients in the subgroups were comparable. The work assessed psychological disorders (anxiety and depression) and cognitive status using specialized scales «HADS» and «SPMSQ».Results. In patients with COVID-19, compared with patients from group 1, there is a more pronounced depressive syndrome (p<0.001); subclinical depression in 26% of patients (p<0.001) and the absence of the latter in group 1; clinically pronounced depression was found in 15% (p=0.007). At the same time, the severity of subclinical symptoms of anxiety syndrome was noted in patients without COVID-19, and clinically significant anxiety was more often observed in recovered patients, although statistical significance was not achieved. When assessing cognitive function, it was found that moderate dysfunction was observed in patients with COVID-19 significantly more often (p=0.001). In the sulodexide group, only mild cognitive dysfunction was detected (14%), and the majority of patients taking sulodexide had no cognitive dysfunction.Conclusion. Thus, in comorbid elderly patients in the post-COVID period, an increase in the number of people with psychocognitive disorders was noted. In this regard, long-term follow-up of patients who have undergone COVID-19 is necessary, both for the dynamic assessment of underlying diseases and the analysis of psychocognitive status. In addition, it should be noted that the drug sulodexide, consisting of a heparin-like fraction and dermatan sulfate, has many pharmacodynamic (anti-inflammatory, angioprotective, anticoagulant, antifibrotic) and pharmacokinetic advantages (safety, the possibility of oral administration) can effectively prevent the development of cognitive dysfunction, which requires even further in-depth research.