Management of asthenic patients after COVID-19

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<0.01); the comparison group had improvements only in 2 (6.7%) patients; the mean score was 14.6±1.2 (p<0.05). Thirty days after the end of therapy, the mean MFI-20 score was 10.7±0.8 in the study group (p<0.01); in the comparison group, the scores did not change from the baseline ones (15.1±0.2) (p<0.05). Conclusion. The multilevel nature of the nervous system lesion in COVID-19 has been revealed, which requires the choice of individual therapy. The investigation shows that it is expedient to incorporate 500-mg Meldonium Organika capsules for the therapy of asthenic syndrome in post-COVID-19 patients.

COVID-19, infectious diseases, therapy, neurology, COVID-19, asthenic syndrome, Meldonium