Management of asthenic patients after COVID-19

DOI: https://doi.org/10.29296/25877305-2020-12-06
Download full text PDF
Issue: 
12
Year: 
2020

Associate Professor M. Zhestikova(1), Candidate of Medical Sciences; Professor M.
Gerasimenko(2), MD; Associate Professor S. Kan(1), MD; V. Minenkov(1), Candidate of Medical Sciences; T.
Aikina(1) (1)Novokuznesk State Institute for Postgraduate Training of Physicians, Branch, Russian Medical
Academy of Continuing Professional Education, Novokuznesk (2)Russian Medical Academy of Continuing
Professional Education, Moscow

Patients with COVID-19 report lack of vitality. This condition is caused by severe hypoxia. Tissue hypoxia is affected by a novel class of drugs called partial fatty acid oxidation (p-FOX) inhibitors; its international nonproprietary name is meldonium. Objective: to evaluate the efficiency of using Meldonium Organika capsules 500 mg in relieving asthenic syndrome in post-COVID-19 patients. Subjects and methods. A total of 128 patients (59 men and 69 women) aged 51 to 54 years were followed up; 52.3% of them complained of chronic, persistent, severe fatigue. A study group included 30 patients with asthenic syndrome lasting at least 2 months; in addition to the standard therapy, the patients took an oral 500-mg Meldonium Organika capsule twice daily for 3 months according to the management protocol for post-COVID-19 patients. The comparison group included patients (n=30) who received stable therapy according to the protocol of a patient’s mindset who underwent COVID-19 with concomitant somatic and neurological pathology that complicates the study; the presence of a history of severe allergic reactions and autoimmune diseases in patients, viral forms of hepetitis (including the carrier of viruses), as well as acute infectious diseases during the 4 weeks preceding blood sampling. Results and discussion. The clinical neurological picture was determined by the involvement of the central mechanisms that regulate the somatosensory system in the pathological process. Before treatment, the patients in the study group had MFI-20 scores of 15.3±0.2; those in the comparison group had 15.2±0.2 scores. After the end of treatment, the study group showed a significant improvement in 26 (86.7%) patients; the mean MFI-20 score was 9.7±1.6 (p

Keywords: 
infectious diseases
therapy
neurology
COVID-19
asthenic syndrome
Meldonium



It appears your Web browser is not configured to display PDF files. Download adobe Acrobat или click here to download the PDF file.

References: 
  1. Coronavirus disease 2019 (COVID-19). World Health Organization Situation Report. URL: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200305-sitrep-45-covid-19.pdf (data obraschenija 17.04.2020).
  2. COVID-19 Strategy Update. World Health Organization. URL: https://www.who.int/publications-detail/covid-19-strategy-update-14-april-2020 (data obraschenija 14.04.2020).
  3. Harvey B.H., Oosthuizen F., Brand L. et al. Stress-restress evokes sustained iNOS activity and altered GABA levels and NMDA receptors in rat hippocampus. Psychopharmacology. 2004; 175: 494–502. DOI: 10.1007/s00213-004-1836-4
  4. Starshinova A.A., Kushnareva E.A., Malkova A.M. i dr. Novaja koronavirusnaja infektsija: osobennosti klinicheskogo techenija, vozmozhnosti diagnostiki, lechenija i profilaktiki infektsii u vzroslyh i detej. Voprosy sovremennoj pediatrii. 2020; 19 (2): 123–31 [Starshinova A.A., Kushnareva E.A., Malkova A.M. et al. New Coronaviral Infection: Features of Clinical Course, Capabilities of Diagnostics, Treatment and Prevention in Adults and Children. Current Pediatrics. 2020; 19 (2): 123–31 (in Russ.)]. https://doi.org/10.15690/vsp.v19i2.2105
  5. Logunova L.V. Novye aspekty v ispol'zovanii Mildronata dlja profilaktiki i korrektsii narushenij adaptatsionnyh protsessov. Vestnik RUDN. Serija: Meditsina. 2009; 1: 81–8 [Logunova L.V. New views of mildronate use for the prevention and correction of impairment of adaptive processes. Vestnik RUDN. Seriya: Meditsina. 2009; 1: 81–8 (in Russ.)].
  6. Negoda S.V., Statsenko M.E., Turkina S.V. i dr. Vlijanie terapii Mildronatom na kognitivnye funktsii u bol'nyh pozhilogo vozrasta s arterial'noj gipertenziej. Kardiovaskuljarnaja terapija i profilaktika. 2012; 11 (5): 33–8 [Nedogoda S.V., Statsenko M.E., Turkina S.V. et al. Mildronate effects on cognitive function in elderly patients with arterial hypertension. Cardiovascular Therapy and Prevention. 2012; 11 (5): 33–8 (in Russ.)]. https://doi.org/10.15829/1728-8800-2012-5-33-38
  7. Popova O.V., Tsirkin V.I., Nureev I.T. Vlijanie Mildronata na sostojanie tsentral'noj nervnoj sistemy u studentov s priznakami sindroma defitsita vnimanija s giperaktivnost'ju. Vestnik NNGU. 2010; 6: 105–12 [Popova O.V., Tsirkin V.I., Nureev I.T. et al. The influence of mildronate on the condition of central nervous system of students with attention deficit hyperactivity disorder (ADHD) syndrome. Vestnik NNGU. 2010; 6: 105–12 (in Russ.)].
  8. Ochsner K., Gross J. Cognitive emotion regulation: insights from social cognitive and affective neuroscience. Curr Dir Psychol Sci. 2008; 17: 153–8. DOI: 10.1111/j.1467-8721.2008.00566.x
  9. Samorodskaja I.V. Mel'donij: obzor rezul'tatov issledovanij. RMZh. 2013; 36: 1818–22 [Samorodskaja I.V. Mel’donij: obzor rezul’tatov issledovanij. RMZh. 2013; 36: 1818–22 (in Russ.)].
  10. Vertkin A.L., Hovasova N.O. Komorbidnost' – novaja patologija. Tehnologii ee profilaktiki i lechenija. Arh vnutr med. 2013; 4: 68–74 [Vertkin A.L., Khovasova N.O. Komorbidnost’ – novaya patologiya. Tekhnologii ee profilaktiki i lecheniya. The Russian Archives of Internal Medicine. 2013; 4: 68–72 (in Russ.)]. https://doi.org/10.20514/2226-6704-2013-0-4-68-72
  11. Morin D., Hauet T., Spedding M. et al. Mitochondria as target for antiischemic drugs. Adv Drug Deliv Rev. 2001; 49: 151–74. DOI: 10.1016/s0169-409x(01)00132-6
  12. Kotov S.V., Isakova E.V., Volchenkova T.V. i dr. Effektivnost' primenenija mel'donija v ostrom periode ishemicheskogo insul'ta. Al'manah klinicheskoj meditsiny. 2015; 39: 75–80 [Kotov S.V., Isakova E.V., Volchenkova T.V. et al. Efficacy of meldonium in acute period of ischemic stroke. Almanac of Clinical Medicine. 2015; 39: 75–81 (in Russ)]. https://doi.org/10.18786/2072-0505-2015-39-75-81
  13. Rozhdestvenskij D.A., Dotsenko E.A., Bobkov Ju.Ja. Mel'donij-Mik® i Mildronat®: Osobennosti farmakologicheskogo dejstvija i ekvivalentnost'. Lechebnoe delo. 2011; 6 (22): 47–51 [Rozhdestvenskii D.A., Dotsenko E.A., Bobkov Yu.Ya. Mel’donii-Mik® i Mildronat®: Osobennosti farmakologicheskogo deistviya i ekvivalentnost’. Lechebnoe delo. 2011; 6 (22): 47–51 (in Russ)].
  14. Zadionchenko V.S., Shehjan G.G., Jalymov A.A. Mesto mel'donija v metabolicheskoj tsitoprotektsii. RMZh. 2013; 9: 448–53 [Zadionchenko V.S., Shekhyan G.G., Yalymov A.A. Mesto mel’doniya v metabolicheskoi tsitoprotektsii. RMZh. 2013; 9: 448–53 (in Russ)].
  15. Dzerve V. MILSS I Study Group. A dose-dependent improvement in exercise tolerance in patients with stable angina treated with mildronate: a clinical trial «MILSS I». Medicina (Kaunas). 2011; 47 (10): 544–51. DOI: 10.3390/medicina47100078
  16. Ramsay R.R., Gandour R.D., van der Leij F.R. Molecular enzymology of carnitine transfer and transport. Biochim Biophys Acta. 2001; 1546: 21–43. DOI: 10.1016/s0167-4838(01)00147-9
  17. Naumova E.M., Borisova O.N., Beljaeva E.A. i dr. Programmy adaptatsii v professional'nom sporte i printsipy ih korrektsii. Vestnik novyh meditsinskih tehnologij. 2016; 23 (2): 240–9 [Naumova E.M., Borisova O.N., Belyaeva E.A. et al. Adaptation programs in professional sports and principles of correction (literature review). Journal of new medical technologies. 2016; 23 (2): 240–9 (in Russ)]. DOI: 10.12737/20453
  18. Rebouche C.J. Kinetics, pharmacokinetics, and regulation of L-carnitine and acetyl-L-carnitine metabolism. Ann NY Acad Sci. 2004; 1033: 30–41. DOI: 10.1196/annals.1320.003