Psychoneurological disorders in the stage of post-COVID syndrome

А im . Generalization and systematization of ideas about the pathophysiological mechanisms of asthenic syndrome development against the background of COVID-19. Materials and methods . The work analyzed scientific articles and monographs devoted to the etiopathogenesis of post-COVID asthenic syndrome (PCAS). The search was carried out by the keywords «COVID-19», «post-COVID syndrome», «psychoneurological disorders», «asthenic syndrome» using the PubMed, Medline, eLibrary.ru databases. Results and discussion . The ideas about the clinical structure of PCAS are systematized, the mechanisms of penetration of the SARS-CoV-2 virus into the nervous system are presented, modern views on the molecular mechanisms of the development of neurological symptoms in COVID-19 convalescents are highlighted. The key pathogenetic links of PCAS are described, including immune deviations associated with cytokine imbalance, oxidative and nitrosative stress reactions with subsequent activation of anaerobic metabolic pathways in brain and muscle tissues; neurometabolic changes accompanied by dysfunction of the serotonergic, dopaminergic, noradrenergic and GABAergic systems. Conclusion . Analysis of world literature data, as well as our own clinical experience, allows us to conclude that psychoneurological disorders associated with COVID-19 infection are multifaceted and complex and are accompanied by highly variable symptoms. At the same time, the existing fragmentary knowledge regarding the pathomechanisms of psychoneurological disorders against the background of COVID-19 dictates an urgent need to continue further research in this area.