Федеральное государственное бюджетное военное образовательное учреждение высшего образования «Военно-медицинская академия имени С.М. Кирова» Министерства обороны Российской Федерации,

The review article is devoted to the analysis of the literature on the various mechanisms of damage to the cardiovascular system in COVID-19. The article briefly outlines the epidemiology and urgency of the COVID-19 problem, describes the features of the clinical picture of heart muscle damage in COVID-19. The pathophysiology, morphology and pathogenetic mechanisms of myocardial involvement in cases of SARS-CoV-2 lesion are considered in detail. The authors present a diagram of various mechanisms of myocardial damage in COVID-19, which includes mediated damage to the heart muscle through angiotensin-converting enzyme 2, myocardial damage caused by hypoxemia, microvascular heart damage, and systemic inflammatory response syndrome. A detailed scheme of cardiomyocyte infection with the involvement of cytokines, which ultimately leads to myocardial remodeling and dilated cardiomyopathy, is presented. The pathophysiological foundations of the development of sudden cardiac death in COVID-19, which include the mechanisms of life-threatening arrhythmias, acute coronary syndrome, and heart failure, are considered. The authors analyzed scientific studies of the toxic effects of COVID-19 drug treatment on the heart muscle, in particular, antiviral, antibacterial, antimalarial agents. Their potential benefits and harms, as well as the likelihood of developing cardiovascular events, in particular sudden cardiac death, were assessed.

The pandemic of a new coronavirus infection (COVID-19) threatened the combat readiness of the Armed Forces (AF) and required the urgent development and implementation of its own measures to limit the spread of the disease. Wide-spread principles to combat this disease, including social distancing, isolation of patients and quarantine of contact persons, are difficult to comply with Navy service. Given the features of habitability, autonomy and distance from the main locations, the experience gained and the measures taken during the outbreak of COVID-19 on the US Navy nuclear aircraft carrier «Theodore Roosevelt» are of great interest. It was important that at the time of diagnosis COVID-19 77% of crew members had no signs of disease, and 43% of them remained completely asymptomatic. The incidence among officers was significantly less than in ordinary and sergeant personnel. None of the officers were hospitalized. People of the white race predominated among the diseased and hospitalized (42,7 per cent and 30,4 per cent, respectively), as well as those associated with reactor operation, weapons and support personnel (27,9 per cent in total). At the same time, those servicemen who strictly followed non-specific preventive measures had a reliably lower infection rate.

Abstract. Clinical and epidemiological and electrocardiographic features of Wolf Parkinson White syndrome in men of military age were studied. The study was a retrospective study with a solid sample of patients. Of the 1,9056 men residents of St. Petersburg between the ages of 18 and 27, Wolf-Parkinson-White syndrome was identified in 107 (0,56%) people. The disease was asymptomatic in 38 (35,5%) patients. All identified individuals with Wolf Parkinson White syndrome, in addition to asthenic Constitution type, which was observed in 68,2% of cases, were assessed for signs of systemic connective tissue involvement. It was found that flat feet, scoliosis or kyphosis, myopia, as well as mitral valve prolapse and abnormally located chords in the left ventricle of the heart are detected in almost every second man of military age. Due to the inability to assess the presence of all signs of systemic connective tissue involvement, the isolation of specific variants of dysplastic phenotypes in patients with Wolf Parkinson White syndrome was not performed. It was found that in the presence of increased dysplastic stigmatization, the clinical course of Wolf Parkinson White syndrome is characterized by a lower number of asymptomatic cases (6,3 and 16,7%, respectively; p0,05), an increase in the frequency of paroxysmal tachyarrhythmias (81,5 and 63,1%, respectively; p0,05) and a high incidence of vegetative-vascular disorders (82,8 and 15,4%, respectively; p0,05).

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