Clinical and pathogenetic mechanisms of cerebrovascular disease development in patients, who have had COVID-19

Background. Recent studies have shown that COVID-19 infection leads to the development of neurological diseases or causes exacerbation and progression of existing neurological diseases. However, despite the large number of studies conducted on this issue, our knowledge of the mechanisms of development and progression of neurological disorders is far from complete and requires further study. This is especially true for cerebrovascular diseases (CVD), the prevalence of which has increased significantly during and after the COVID-19 pandemic. Purpose – of our study was to investigate the clinical and pathogenetic mechanisms of CVD development in patients with COVID-19, to identify risk groups and biomarkers of their development and progression. Materials and Methods. We examined 48 patients aged 42 to 74 years with CVD. The main group consisted of patients with clinical and paraclinical signs of chronic cerebral ischaemia who had documented COVID-19. The comparison group (control) consisted of 48 patients of the same age with chronic cerebral ischaemia without COVID-19. It was found that the structure of clinical manifestations of chronic cerebral ischaemia was dominated by asthenic, cephalgic, vestibulo-ataxic syndromes, cognitive and psychoemotional disorders, and severe autonomic disorders. Results. The most significant factors in the development of CVD in patients after COVID-19 are age, history of arterial hypertension, diabetes mellitus, obesity, severity of the acute period of COVID-19 and vascular endothelial condition. Conclusion. On the basis of the conducted studies, the mechanisms of CVD formation in patients with COVID-19 were proposed. The presence of cardiovascular risk factors in patients and the prolonged course of the acute period of coronavirus infection lead to the development of neuroinflammation, coagulation disorders, endothelial dysfunction, cerebral hypoperfusion, and, as a result, the development of acute and chronic cerebrovascular disorders.