LONG-TERM PSYCHIATRIC SEQUELAE OF SARS-COV-2 INFECTION

According to various authors, the metabolic syndrome is common in more than 50 % of patients with schizophrenia. One of the reasons for the formation The objective of this position and review paper is to draw an attention of the specialists to the problem of long-lasting sequelae in COVID-19 patients, its early diagnosis and therapeutic correction. Along with theoretical aspects of post-COVID syndrome (PCS) definition and the place of psychiatric symptoms in this multisystem disorder, the stages of its development are highlighted and a step-by-step algorithm for its screening and early diagnosis in the primary care using simple validated questionnaires is proposed. A secondary objective of this review was to select questionnaires that are the most sensitive, valid, and easy for the implementation in primary health care network. According to the literature, the most common mental disorders of PCS are asthenia (17-72 %), cognitive dysfunction (12-55 %), anxiety (10-48 %), depression (7-43 %), insomnia (26-40%) and stress disorders (6-31 %), which often appear in clinical practice as a peculiar asthenic-neurotic syndrome in combination with depression and cognitive deficits. This psychopathological symptom complex occurs twice as often in patients with COVID-19 as in patients with other acute respiratory viral infections, and is detected in almost one third of all cases and in two thirds of patients with severe coronavirus infection that required hospital admission. Despite the lack of a clear understanding of the pathogenesis, risk factors, prognosis and outcomes of psychopathological symptoms of PCS, it should be regarded as COVID-19 complication that is associated with direct viral damage of the central nervous system (CNS), negative effects of other organ systems damage (primarily cardiovascular and respiratory), and stress response. Considering that the majority of mental health complications, such as asthenia and cognitive deficit, are often accompanied by neurological symptoms, are closely adhered to them and indicate damage of the CNS, it is proposed to define neuropsychiatric PCS as “Brain Long COVID”. The primary health care network and neuropsychiatric institutions should be prepared to diagnose these patients and provide them with adequate care.