Journal of Clinical PracticeJournal of Clinical PracticeКлиническая практика2220-30952618-8627Eco-Vector62947510.17816/clinpract629475ReviewsНаучные обзорыReview ArticlePost-COVID asthenia, sarcopenia and muscle weakness among geriatric patientsПостковидная астения, саркопения и генерализованная мышечная слабость у гериатрических больныхhttps://orcid.org/0000-0003-0458-07036098-1321BelopasovVladimir V.БелопасовВладимир Викторович
Russian Federation

MD, PhD, Professor

д-р мед. наук, профессор

belopasov@yandex.ruhttps://orcid.org/0000-0002-9777-51307599-0820VeselovaDaria K.ВеселоваДарья Константиновна
Russian Federation
dorozhe_zolota007@mail.ruAstrakhan State Medical UniversityАстраханский государственный медицинский университетClinic CityКлиника-Сити250620241507202415251582703202419052024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://clinpractice.ru/clinpractice/article/view/629475

Sarcopenia, asthenia, and motor activity restriction are common among geriatric patients in the post-COVID period. The SARS-CoV-2 virus triggers a cytokine storm in the human body and induces a direct viral effect on skeletal muscles. Manifestations of post-acute sequelae of COVID-19 (PASC) can include organ and system dysfunction, asthenia, muscle weakness, dyspnea, chest pain, cognitive impairment, depression, anxiety, and sleep disorders. Hypoxemia, comorbidity, and prolonged inactivity contribute to changes in the structure and functionality of the muscular fibers. One of the recent studies is ALMI-index, which indicates that a decrease in muscle mass of the upper and lower extremities may cause functional limitations in patients with long-COVID conditions. Rehabilitation of patients with post-COVID syndrome involves daily exercise with weights, considering load tolerance; mandatory medication; and nutritional and psychological support.

Астения, саркопения, ограничение двигательной активности значительно распространены среди гериатрических пациентов в постковидном периоде. Внедрение SARS-CoV-2 в организм человека запускает системные воспалительные реакции, оказывая прямое и опосредованное патологическое воздействие на скелетные мышцы. Проявлениями постковидного синдрома могут быть дисфункциональные нарушения органов и систем, включающие астению, мышечную слабость, одышку, боль в груди, когнитивные нарушения, депрессию, тревогу и нарушения сна. Сопутствующие гипоксемия, коморбидность и длительная гиподинамия способствуют изменениям структуры и функциональности мышечных волокон. Одним из новейших диагностических трендов является акцент на оценку индекса ALMI, свидетельствующего о том, что снижение мышечной массы верхних и нижних конечностей является возможной причиной развития функциональных ограничений у пациентов, перенёсших COVID-19. Реабилитация пациентов, перенёсших COVID-19, предполагает ежедневное выполнение физических упражнений с отягощением с учётом переносимости нагрузок, а также обязательную медикаментозную, нутритивную и психологическую поддержку.

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