The Post-COVID-19 cognitive impairment. A modern view of the problem, pathogenesis and treatment
Open Access
- 30 December 2021
- journal article
- Published by V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology in V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY
- Vol. 57 (4), 97-105
- https://doi.org/10.31363/2313-7053-2021-57-4-97-105
Abstract
COVID-19 infection is a significant and poorly understood problem of modern world medicine. As the virus spreads, data on the clinical picture of the disease and damage to the nervous system are accumulating. Symptoms such as fatigue, anxiety, depression, sleep disturbances and many other neurological and somatic symptoms are often recorded, persist for a long time even after the acute infectious stage of the disease has been stopped, and make it difficult for the patient to fully recover. These symptoms occur even with a mild disease and persist for many months. One of the most common and disabling symptoms of post-COVID syndrome is cognitive impairment, in the formation of which, in addition to the direct ability of the virus to penetrate the nervous system and pathology of the microvasculature, various pathological mechanisms are involved, including dysregulation of cholinergic transmission. A comprehensive approach is important in the treatment of cognitive impairment; it is advisable to use both medication and non-medication methods. The main approaches to the treatment of secondary cognitive disorders are based on the hypothesis of replenishing the defect in mediator systems, including those associated with the death of cholinergic neurons. With these abnormalities, it is advisable to replenish acetylcholine. Among the precursors of choline, choline alfoscerate occupies a special place due to its proven efficacy in the treatment of neurodegenerative diseases, as well as due to data on its multifactorial action. The article presents the actual literature data on the mechanisms of development and features of the clinical manifestations of post-COVID cognitive impairment, as well as materials of experimental and clinical studies of the drug choline alfoscerate (Gliatilin).Keywords
This publication has 59 references indexed in Scilit:
- Revisiting choline alphoscerate profile: a new, perspective, role in dementia?International Journal of Neuroscience, 2013
- Effectiveness of nootropic drugs with cholinergic activity in treatment of cognitive deficit: a reviewJournal of Experimental Pharmacology, 2012
- Long-term Cognitive Impairment and Functional Disability Among Survivors of Severe SepsisJAMA, 2010
- Acute Respiratory Distress Syndrome, Sepsis, and Cognitive Decline: A Review and Case StudySouthern Medical Journal, 2009
- The Review of “The relationship between encephalitis lethargica and influenza: A critical analysis”Journal of NeuroVirology, 2008
- Effect of treatment with choline alphoscerate on hippocampus microanatomy and glial reaction in spontaneously hypertensive ratsBrain Research, 2006
- The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool For Mild Cognitive ImpairmentJournal of the American Geriatrics Society, 2005
- Transient cerebral ischemia induces site-specific hyperphosphorylation of tau proteinBrain Research, 2004
- CENTRAL CHOLINERGIC SYSTEMS AND COGNITIONAnnual Review of Psychology, 1997
- “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinicianJournal of Psychiatric Research, 1975