http://doi.org/10.26347/1607-2502202105-06011-017
Background. Already the first descriptions of the clinical course of the new coronavirus infection COVID-19 included reports of frequent lesions of the nervous system — from strokes to necrotizing encephalopathy and Guinein—Barrйsyndrome. Later, descriptions of the delayed disorders appeared: long COVID, post-COVID syndrome. There is no generally accepted clinical picture, classification and epidemiology of this syndrome. At the same time for six months, the UK has seen the 4-time increase of re-hospitalization among those discharged from hospitals after an infection and the 8-time-increase of mortality among them.Objective. Description of the symptoms of the post-COVID syndrome with the formation of a «disease character» and assessment of possible pathogenetic mechanisms of the development of this condition.Methods. An analysis of the symptoms described by patients in social networks was carried out, aquestionnaire was formed, including the most common complaints, in October 2020, a survey of participants in social networks was conducted, 1400 questionnaires were analyzed. Based on the results of the analysis in February-March 2021, a second revised questionnaire was uploaded to the MeDiCase platform, which was used by 194 respondents. Since 1st September 2020, 292 patients with the post-COVID have been consulted online. All participants received recommendations for a set of laboratory tests, which included an assessment of the inflammatory status and intravascular blood coagulation. The results of information support allowed the authors to form a classification of this state.Results. The image of the disease included 29 main symptoms and signs, which made it possible tosubstantiate the hypothesis about the relationship between the main symptoms of the post-COVIDsyndrome and the development of meningoencephalitis caused by thrombovasculitis. The post-COVID meningoencephalitis (thrombovasculitis), hypochondriacal variant, post-COVID vasculitis of micro- and macrovascular in the skin and its appendages, secondary, including iatrogenic, functional-morphological changes in tissues and systems, certain syndromes of autoimmune reactions, post-vaccination covid-like syndrome. To confirm this hypothesis, research should be directed towards the study of the morphology of the nervous tissue, including the use of immunohistochemical methods, the assessment of the immunological status and processes of intravascular blood coagulation.Interpretation. A group of 29 common symptoms and signs of post-covid syndrome was formed: 17 of them are associated with dysfunction of the nervous system, 8 signs may be neurogenic in nature, and 4 relate to manifestations of vasculitis. In the pathogenesis of the post-COVID syndrome, there is meningoencephalitis associated with thrombovasculitis. Highlighted in the classification of the scallop syndrome require the development of complex pathogenetic therapy.
Ключевые слова: COVID-19, post-COVID syndrome, MeDiCase, SARS-CoV-2