Clinical and Psychological Aspects of Asthenia and Anxiety in COVID-19 Patients

Relevance. Among individuals who have recovered from COVID-19, anxiety, depression, sleep disturbances, and asthenia are highly prevalent; these symptoms are observed both during the acute phase of the disease and after recovery. Asthenia is characterized by exacerbation of emotional and motivational dysfunction, impaired cognitive performance, pain symptoms, and autonomic dysregulation. Intention: to investigate the prevalence of the asthenic component of anxiety and its associations 2 years after recovery from COVID-19. Methodology. 70 people (51.4 % women) aged 56 ± 9 years in 3 and 12 months after recovery from lung damage COVID-19 were examined. Data included structured interview, scores on the GAD-7, PHQ-9 and personality anxiety subtest of the IAT scale, results of examinations by a psychiatrist and a cardiologist. Results and discussion. The asthenic component of anxiety exceeded the norm in 32.9 % of the examined patients, asthenia symptoms were detected in 71.4 %, affective symptoms - in more than 40 %. There were intensive manifestations of anxiety, depression and subjective disturbances of cognitive processes in patients with the asthenic anxiety above the norm. The prevalence of asthenia (p = 0.002, 87.0 % and 47.8 %) and the severity of depression manifestations (p = 0.030, 6.60 [4.00; 9.00] and 5.00 [3.00; 8.00]) decreased by a year in this group. Attention deficits correlated with heart rate 3 months after recovery (r = 0.532, p = 0.034) and depression severity with heart rate 9 months later (r = 0.474, p = 0.022). In the subjects with normatively expressed asthenic anxiety the severity of manifestations of affective disorders, asthenia (p = 0.006, 63.8 % and 34, 0 %) and adaptation disorders (p = 0.012, 21.3 % and 4.3 %). In addition, there were the inverse correlation between anxiety and diastolic arterial pressure (r= −0.353, p = 0.015), emotional lability and heart rate (r = −0.318, p = 0.029), impaired attention and diastolic arterial pressure (r = −0.308, p = 0.035) remained during the observation period. First, clinically expressed symptoms of asthenia are used to form in individuals with asthenic anxiety, who are constitutionally more sensitive to stressful events. In both groups of subjects, somatisation is a compensatory mechanism based on regression and reactive formations. In patients with normative asthenic anxiety, somatisation is based on the suppression of over-expressed experiences, on denial and compensation. There is a representation of a special personality predisposition in patients with excessive asthenic anxiety. Conclusion. Assessing the severity of asthenic personal anxiety is crucial in patients with somatic disorders. Regardless of its intensity, when working with individuals prone to elevated blood pressure, clinicians should attend to personality characteristics and the specific interplay between emotional and somatic domains.