Особенности течения гипермобильного синдрома в постковидном периоде и ведение пациентов

Abstract

Aim: to conduct a comparative analysis of the clinical manifestations and course patterns and needs for medical interventions in two groups of patients with joint hypermobility syndrome (JHS) (after COVID-19 and without it). Patients and Methods: two groups of patients with JHS were observed for 2 months: those who had COVID-19 (n=37) and those without COVID-19 (n=21) aged 18 to 55 years. The inclusion criterion was the absence of injuries, as well as inflammatory and acute-phase changes in blood values recorded in the ambulatory medical record. All complaints were assessed by organs and systems with the identification of the most common ones: clinical manifestations in the post-COVID period, the intensity of the musculoskeletal pain syndrome according to the visual analog scale (VAS), the levels of situational and personal anxiety degree (according to the Spielberger-Hanin test), the exclusion of depression according to the Hospital Anxiety and Depression Scale (HADS), life quality (according to the Russian version of the SF-36 v.2тм questionnaire. Results: the severity of pain in the first group of patients in the categories of "moderate and high pain" was significantly more common versus the group 2 without COVID-19. For the first time, complaints concerning vegetative-vascular dystonia of permanent (heartbeat, tachycardia, spontaneous dyspnea) and paroxysmal (panic attacks) origins were significantly more common in the group of patients who experienced COVID-19. Associations with a higher level of anxiety and a decrease in the life quality were revealed in the group 1 who experienced COVID-19. To relieve musculoskeletal pain, a group of NSAIDs was commonly prescribed in a standard therapeutic dose for 7–10 days. Incomplete pain relief, as well as two- and threefold relapses of musculoskeletal pain were noted in the group 1. The need for prescription of tofisopam anxiolytic 0.05 mg 3 times a day was due to the high and moderate levels of anxiety and permanent and paroxysmal vegetative manifestations in the group experienced COVID-19. The preservation of asthenic syndrome caused the need to prescribe a drug that regulates metabolic processes in the central nervous system: sulbutiamine 200 mg in the morning and at lunch for 4 weeks. After 1 month of treatment with tofisopam and sulbutiamine, there was a significant decrease in the anxiety level, a decrease in the intensity and relief of musculoskeletal pain, as well as an improvement in the life quality. Conclusion: the administration of adjuvant therapy in the form of an anxiolytic (tofisopam) and a drug regulating metabolic processes in the central nervous system (sulbutiamine) to the standard analgesic therapy with NSAIDs in patients who have experienced COVID-19 with severe musculoskeletal pain, vegetative and anxiety disorders leads to a significant reduction or relief of musculoskeletal pain syndromes and an improvement in the life quality. KEYWORDS: joint hypermobility syndrome, COVID-19, joint pain syndrome, post-COVID-19 period. FOR CITATION: Viktorova I.A., Ivanova D.S., Moiseeva M.V. et al. Course patterns and patient management with joint hypermobility syndrome in the post-COVID-19 period. Russian Medical Inquiry. 2022;6(3):133–139 (in Russ.). DOI: 10.32364/2587-6821-2022-6-3-133-139.