Новая коронавирусная инфекция COVID-19 вызывает поражение многих органов и систем, является полиорганным заболеванием. Многие исследователи изучают связь новой коронавирусной инфекции с полиморбидной патологией, старческой астенией, саркопенией. Вирус SARSCoV-2 обладает свойством тропности к нервной ткани, поэтому в спектр клинических проявлений и последствий перенесенной болезни могут присоединяться ольфакторные, вкусовые нарушения, а также нарушения когнитивных функций. Болезнь Альцгеймера является самой частой причиной деменции в мире. Представляет интерес наличие связи между перенесенной коронавирусной инфекцией и развитием когнитивных нарушений, в том числе болезни Альцгеймера. The new coronavirus infection COVID-19 causes damage to many organs and systems, is a multi-organ disease. Many researchers are studying the relationship of the new coronavirus infection with polymorbid pathology, frailty, sarcopenia. The SARS-CoV-2 virus has the property of neurotropism, therefore, olfactory, taste disorders, as well as cognitive impairments can join the spectrum of clinical manifestations and consequences of the disease. Alzheimer’s disease is the most common cause of dementia in the world. It is of interest that there is a link between the coronavirus infection and the development of cognitive impairment, including Alzheimer’s disease.

In medical practice, there are often patients who have several diseases at once, both pathogenetically related to each other and not related. The article discusses endocrine diseases in which there are manifestations from the cardiovascular system - disorders of carbohydrate metabolism, pathology of the thyroid gland, adrenal glands and acromegaly. These diseases reduce the quality of life of patients and increase the risks of cardiovascular complications. The article also discusses the features of cardiovascular manifestations in these diseases and indications for differential diagnosis. Type 2 diabetes mellitus significantly increases the cardiovascular risks, which leads to a more rapid progression of atherosclerosis. Moreover, vascular disorders are detected already at the stage of prediabetes. Therefore, it is necessary to identify disorders of carbohydrate metabolism as early as possible and initiate appropriate therapy. When prescribing antihyperglycemic therapy, preference should be given to drugs with a low risk of hypoglycemia (metformin, glucagon-like peptide-1 agonists, type 2 sodium glucose co-transporter inhibitors). Thyroid dysfunctions - thyrotoxicosis and hypothyroidism - also have an adverse effect on the cardiovascular system. Hypothyroidism often has a blurred clinical picture and manifestations from various organs, and therefore it is diagnosed late. Therefore, an active diagnosis of this condition should be carried out in persons with a combination of a wide variety of diseases, especially in old age. Adrenal pathology (pheochromocytoma, hyperaldosteronism and hypercorticism) is manifested by an increase in blood pressure. Differential diagnosis is worthwhile in case of severe arterial hypertension or resistance to antihypertensive therapy. In acromegaly, lesions of the cardiovascular system are quite common and are the main cause of death in these patients. Therefore, early detection of this pathology is especially important. Thus, such patients should be monitored jointly by a cardiologist and an endocrinologist, and timely diagnosis and treatment of endocrine pathology will help reduce their cardiovascular risks.

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Hypothyroidism is one of the most common diseases of the endocrine system. It is more often recorded in older women. This disease is characterized by nonspecific symptoms and a blurred clinical picture. Patients often have many symptoms from various organs and systems. Because of this, hypothyroidism often remains unrecognized, and patients are not prescribed the necessary therapy on time. Doctors of various specialties should pay attention to the symptoms that may manifest as hypothyroidism. This is especially true for elderly patients. As a screening, the definition of thyroid-stimulating hormone (TSH) is used. First of all, attention should be paid to the pathology of the cardiovascular system, the presence of arterial hypertension, often diastolic and poorly controlled, a decrease in stroke volume and heart rate. Also, in hypothyroidism, lipid metabolism disorders, an earlier onset of atherosclerosis, a connection with metabolic syndrome and type 2 diabetes mellitus were noted. Therefore, it is recommended to diagnose hypothyroidism in patients with these diseases. Screening should also be done in the presence of neurological disorders, depressive and anxiety disorders, gastrointestinal diseases, and hematological disorders (anemias). The determination of TSH is included in the examination plan for infertility, and may also be necessary for other disorders of the reproductive system: menstrual irregularities in women and androgen deficiency in men. Treatment of overt hypothyroidism consists in the appointment of replacement therapy with levothyroxine. If subclinical hypothyroidism is detected, the question of treatment is decided individually and depends on the level of TSH, the patient’s age, and the clinical manifestations of the disease.

Hypothyroidism is the most common endocrine disease after diabetes mellitus. Its frequency depends on age, sex and iodine intake. The highest prevalence of hypothyroidism is observed in older women. Chronic autoimmune thyroiditis is the most common cause of this condition. The peculiarity of hypothyroidism is an erased clinical picture, diversity and nonspecific symptoms. This makes it difficult to diagnose the disease, leads to an erroneous diagnosis and later detection of thyroid insufficiency. This article discusses the various «masks» of hypothyroidism and peculiarities of clinical manifestations. The main «masks» are: cardiological, dermatological, urological, gastroenterological, endocrine and reproductive system disorders, neurological, psychiatric, hematological, rheumatological. Free thyroxine and thyroid-stimulating hormone are used to diagnose hypothyroidism, as well as antibody titer to thyroid peroxidase and thyroglobulin to detect chronic autoimmune thyroiditis. Levothyroxine preparations are used as a substitution therapy. The dose of the drug depends on the age of the patient and the presence of cardiovascular disease. Patients under 50 years of age without a severe concomitant cardiovascular disease are given 1.6 µg of levothyroxine per kg of body weight. In persons over 50 years of age with cardiovascular diseases, the drug dose is prescribed at the rate of 0.9 µg per kg of body weight. The therapy starts with small doses, slowly increasing it under the control of electrocardiography. At occurrence or strengthening of symptoms of angina a dose of levothyroxine is reduced to the previous one and the cardiovascular therapy is corrected. Evaluation of the effectiveness of the treatment is carried out on the level of thyroid hormone.