FATIGUE IN PATIENTS WITH LONG COVID.

Purpose of the study - to characterize the metabolomic profile in patients with fatigue developing within the Long COVID, during dynamic observation. 24 patients diagnosed with U09.9 "Condition after COVID-19 unspecified" were included in a prospective study. Patients were recommended to engage in physical activity, which included moderate aerobic activity such as walking for 45 minutes a day, three days a week. Clinical assessment by scales (Modified Medical Research Council dyspnea scale; 6-minute walk test; Multidimensional fatigue inventory scale; Barthel index), and determination of metabolomic parameters were performed on days 1 and 14-18 of the study. During the observation period, lactate, fumaric acid, symmetrical dimethylarginine, asymmetric dimethylarginine remained above the reference values. The level of adipic acid returns to normal values. As a result of performing physical activity, such as walking, results on the Modified Medical Research Council scale dyspnea scale, Multidimensional fatigue inventory scale, 6 Minutes Walking Test and Barthel Index improve (p<0,001). Metabolic profile of patients with Long COVID demonstrates the complex of abnormalities at 60 days after the onset of the disease. These metabolic changes are point to possible therapeutic targets for specific pathogenetic pharmacotherapy.