Course patterns and patient management with joint hypermobility syndrome in the post-COVID-19 period
DOI: 10.32364/2587-6821-2022-6-3-133-139
I.A. Viktorova1, D.S. Ivanova1, M.V. Moiseeva1, R.Sh. Kochimov2, A.M. Adyrbayev1,3
1Omsk State Medical University, Russian Federation
2City Outpatient Clinic No. 4, Omsk, Russian Federation
3Clinical Medical and Surgical Center, Omsk, Russian Federation
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 vegeta tive 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.
About the authors:
Inna A. Viktorova — D. Sc. (Med.), Professor, Head of the Department of Outpatient Therapy and Internal Diseases, Omsk State Medical University; 12, Lenina str., Omsk, 644099, Russian Federation; chief supernumerary specialist in internal medicine and general practice Ministry of Health of the Omsk Region; ORCID iD 0000-0001-8728-2722.
Darya S. Ivanova — C. Sc. (Med.), Associate Professor of the Department of Outpatient Therapy and Internal Diseases, Omsk State Medical University; 12, Lenin str., Omsk, 644099, Russian Federation; ORCID iD 0000-0003-3668-1023.
Marina V. Moiseeva — C. Sc. (Med.), Associate Professor of the Department of Outpatient Therapy and Internal Diseases, Omsk State Medical University; 12, Lenin str., Omsk, 644099, Russian Federation; ORCID iD 0000-0003-3458-9346.
Roman Sh. Kochimov — general practitioner, City Outpatient Clinic No. 4; 10, bldg. 2, Korolev Ave, Omsk, 644045, Russian Federation; ORCID iD 0000-0002-1366-467X.
Albert M. Adyrbaev — C. Sc. (Med.), Head of the Day Hospital of the Clinical Medical and Surgical Center; 105, Bulatova str., Omsk, 644007, Russian Federation; Assistant Professor of the Department of Outpatient Therapy and Internal Diseases, Omsk State Medical University; 12, Lenin str., Omsk, 644099, Russian Federation; ORCID iD 0000-0003-1003-8953.
Contact information: Inna A. Viktorova, e-mail: vic-inna@mail.ru.
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interests.
Received 02.02.2022.
Revised 28.02.2022.
Accepted 25.03.2022.
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