Changes in Psychological Profile and Cognitive Function in Patients with Arterial Hypertension Who Have Suffered From COVID-19 Under the Influence of Treatment

Oleksandr Kuryata, Oleksandr Stadnik
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Abstract

Today, the issue of treatment and rehabilitation of patients with COVID-19 is extremely relevant. A disease that has shaken the medical community, even after the patient recovers, can have serious consequences for health in the future. The greatest concern in the post-covid period is caused by rather serious and long-term complications (especially in patients who have experienced a severe form of COVID-19), which include: cardiovascular (damage to the heart muscle, exacerbation and progression of hypertension), respiratory, neurological (disturbance of sensation taste and smell, sleep disorders), psychological (depression, anxiety, mood swings) outcomes. In the modern population, there is an increased level of cognitive disorders. They have multifactorial nature, in particular, one of such pathogenetic factors is arterial hypertension (AH) and its complications, the frequency of post-stroke cognitive impairment from mild to severe grade reaches 60% during the first year. On the other hand, according to observations, treatment of AH can reduce the risk of dementia development. The results of the data analysis showed a higher prevalence of cognitive impairment in patients with AH in the post-epidemic period than in patients with elevated blood pressure (BP) who did not suffer from COVID-19. The objective: to analyze the frequency of anxiety-depressive disorders and cognitive function in patients with medically controlled AH who experienced COVID-19, and to evaluate the effectiveness of additional use of a combination of L-carnitine, L-arginine and coenzyme Q10 in the post-covid period. Materials and methods. 53 patients (24 women and 29 men) with a diagnosis of AH who treated with drug antihypertensive therapy and who recovered from COVID-19, were included in a prospective single-center study. Questionnaires (MMSE, SSS-8, PHQ-9) were chosen to assess anxiety-depressive disorders and cognitive function. The study participants were divided into two groups that did not differ in age and gender. In the first group standard treatment was added with a combination of L-arginine, L-carnitine and coenzyme Q10, the patients in the second group received standard therapy. Results. An additional effect on improved BP control only when used drug therapy in a complex with a combination of L-arginine, L-carnitine and coenzyme Q10 was determined, as well as a positive effect on improved the clinical condition of patients with AH, restoration of the psychological state after a recovery from respiratory infection SARS-COV- 2. Conclusions. The patients with AH who have suffered from COVID-19 often have psychological changes and impaired cognitive function under the conditions of medical BP control. The use of a combination of L-arginine, L-carnitine and coenzyme Q10 as part of complex therapy contributed to a more effective recovery of psychological and cognitive disorders, improvement of the subjective condition of patients due to the additional positive effect on the control of BP and heart rate.
COVID-19治疗影响下动脉高血压患者心理状况和认知功能的变化
如今,COVID-19 患者的治疗和康复问题极为重要。这种震撼医学界的疾病,即使在患者康复后,也会对未来的健康造成严重影响。COVID-19 后期最令人担忧的是相当严重的长期并发症(尤其是经历过严重 COVID-19 的患者),其中包括:心血管(心肌损伤、高血压加重和恶化)、呼吸系统、神经系统(味觉和嗅觉障碍、睡眠障碍)、心理(抑郁、焦虑、情绪波动)等方面的后果。它们具有多因素的性质,尤其是动脉高血压(AH)及其并发症是其中的致病因素之一,卒中后认知障碍从轻度到重度的频率在第一年内达到 60%。另一方面,根据观察,治疗动脉高血压可以降低痴呆症的发病风险。数据分析结果显示,与未发生COVID-19的血压(BP)升高患者相比,AH患者在疫情后时期的认知障碍发生率更高。目的:分析经历过COVID-19的药物控制AH患者的焦虑抑郁障碍发生频率和认知功能,并评估在COVID后时期额外使用左旋肉碱、左旋精氨酸和辅酶Q10组合的有效性。53名确诊为AH的患者(24名女性和29名男性)被纳入了一项前瞻性单中心研究,这些患者接受了药物降压治疗,并从COVID-19中康复。调查问卷(MMSE、SSS-8、PHQ-9)用于评估焦虑抑郁障碍和认知功能。研究参与者被分为年龄和性别无差异的两组。第一组患者在标准治疗的基础上添加了左旋精氨酸、左旋肉碱和辅酶Q10的组合,第二组患者则接受标准治疗。结果表明,只有在使用左旋精氨酸、左旋肉碱和辅酶 Q10 复方药物治疗时,才会对改善血压控制有额外效果,同时对改善 AH 患者的临床状况、恢复呼吸道感染 SARS-COV- 2 后的心理状态也有积极作用。在药物控制血压的条件下,COVID-19 导致的 AH 患者往往会出现心理变化和认知功能受损。使用左旋精氨酸、左旋肉碱和辅酶Q10组合作为复合疗法的一部分,有助于更有效地恢复心理和认知障碍,由于对血压和心率控制的额外积极影响,改善了患者的主观状况。
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