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Согласно современным представлениям, новая коронавирусная инфекция COVID-19 (от англ. COrona VIrus Disease – 2019) — острое инфекционное заболевание, вызываемое новым штаммом коронавируса SARS-CoV-2 с аэрозольно-капельным и контактно-бытовым механизмом передачи, патогенетически характеризуется виремией, локальным и системным иммуновоспалительным процессом, гиперактивностью коагуляционного каскада, эндотелиопатией и гипоксией, приводящими к развитию микро- и макротромбозов. Основным источником инфекции является больной человек, в том числе находящийся в инкубационном периоде заболевания. Наибольшую опасность для окружающих представляет человек в последние два дня инкубационного периода и первые дни болезни. Новая коронавирусная инфекция у медицинских работников может рассматриваться как профессиональное заболевание, если инфицирование произошло при выполнении ими профессиональных обязанностей. В Самарском регионе в 2020-2021 гг. у медицинских работников диагностировано 146 случаев острого профессионального заболевания, обусловленного новой коронавирусной инфекцией COVID-19, из которых 72 диагноза (48,63%) установлено посмертно. В 2021 г. установлено 6 диагнозов хронических профессиональных заболеваний, связанных с перенесенной коронавирусной инфекцией, определивших стойкую утрату трудоспособности. Наличие тяжелых осложнений новой коронавирусной инфекции и утрата трудоспособности придают актуальность анализу особенностей профессиональных заболеваний медицинских работников с целью улучшения их диагностики, совершенствования профилактики, лечения и реабилитации. Одним из важнейших проявлений новой коронавирусной инфекции является поражение сердечно-сосудистой системы. Представленный клинический случай отражает один из таких возможных вариантов серьезных поражений – миокардита, который привел к развитию нарушений ритма. В статье представлены принципы и результаты медицинской экспертизы, проведенной в целях установления причинно-следственной связи заболевания с профессиональной деятельностью медицинского работника. According to modern ideas, the pathogenesis of the new coronavirus infection COVID-19 (from the English Corona Virus Disease-2019) is an acute infectious disease caused by a new strain of SARS-CoV-2 coronavirus with an aerosol-drip and a contact-household transmission mechanism) is characterized and the systemic immunospitalus process, hyperactivity of the coagulation cascade, endotheliopathy and hypoxia, leading to the development of microtrombs and mactrombs. The main source of infection is a sick person, including the disease in the incubation period. The greatest danger to others is a person in the last two days of the incubation period and the first days of the disease. A new coronavirus infection in medical workers can be considered as an occupational disease if the infection occurred while they were performing their professional duties. In the Samara region in 2020-2021, 146 cases of acute occupational disease caused by the new coronavirus infection COVID-19 were diagnosed to medical workers, of which 72 diagnoses (48.63%) were established posthumously. In 2021, 6 diagnoses of chronic occupational diseases associated with a coronavirus infection were established, which determined persistent disability. The presence of severe complications of a new coronavirus infection, disability, give relevance to the analysis of the features of occupational diseases of medical workers in order to improve their diagnosis, improve prevention, treatment and rehabilitation.One of the most important manifestations of the new coronavirus infection is the defeat of the cardiovascular system. The presented clinical case reflects one of such possible variants of serious lesions – myocarditis, which led to the development of rhythm disturbances. The article presents the principles and results of a medical examination conducted in order to establish a causal relationship of the disease with the professional activity of a medical worker.

When conducting a comprehensive examination of 145 people with various forms of vibration disease (VD) (first degree VD from exposure to local vibration, second degree VD from exposure to local vibration, second degree VD from exposure to local vibration in combination with hypertension, first degree VD from exposure to general vibration, second degree VD from exposure to general vibration, second degree VD from exposure to general vibration in combination with hypertension) and 30 people in the control group during the integrative anxiety test, an increased level of personal anxiety was revealed in patients with VD, both in the local vibration group and in the group of general vibration, as well as in combination with arterial hypertension (AH), regardless of the vibration type. In the study of the structure of personal anxiety, an increase in the level of the asthenic component of anxiety, emotional discomfort,and prospects assessment of more than 6.0 stanines was found. In the study of situational anxiety, the most pronounced changes in its structure were found in patients with vibration disease in combination with hypertension, regardless of the vibration type. In the structure of situational anxiety in patients with second degree VD from exposure to general vibration and in combination with AH, regardless of the vibration type, the levels of the asthenic component of anxiety and prospects assessment were signifi cantly increased, more than 6 stanines. In patients with vibration disease, both from the impact of local and general vibration and in combination with AH, there is a predominance of destructive psychological defenses (denial and projection) over constructive defenses (compensation and rationalization).

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The results of the study of the main indicators of occupational morbidity in the Samara Region for the period 2015-2019 are presented. The analysis of the structure of occupational morbidity taking into account nosological forms and professions is carried out.