Introduction. Recent publications indicate that the most common comorbidities in hospitalized patients with coronavirus infection were arterial hypertension (AH), diabetes mellitus (DM), and coronary heart disease. However, the peculiarities of AH course in post-COVID-19 patients, especially with concomitant DM, are insufficiently covered in the relevant literature. The aim of the study. Тo investigate the peculiarities of hypertension course in patients with concomitant diabetes mellitus previously affected with COVID-19 infection. Materials and methods. We examined 48 patients with essential hypertension of stage II-III of 1-3 degrees, and concomitant DM, previously affected with Covid-19, 52-72 years of age. Results. It has been estimated that more than 1/3 of patients with hypertension who relapsed to COVID-19 complained of frequent headaches, palpitations, coughs, muscle and joint pain, fatigue and sleep disturbances. However, patients with concomitant DM were significantly more likely to complain of general weakness and indigestion. In many patients, regardless of the presence of concomitant pathology, in the postcocious period there was indicated an increase in C-reactive protein more than 3 mg/l and enhanced fibrinogen levels, indicating an increased risk of cardiovascular complications in this group patients. Most patients experienced worsening of blood pressure control during COVID-19 treatment. Uncontrolled hypertension was significantly more common in patients hospitalized for the treatment of acute COVID-19, regardless of DM presence. Conclusions. In patients with AH and concomitant DM significantly more often (76.0 % of cases (p is equal to 0.01)) – compared to patients with AH without DM (60.9 %) was detected uncontrolled hypertension in the post-COVID period. Worsening of blood pressure control in patients with concomitant DM is significantly more common (p value less than 0.001) in those patients who took three or more antihypertensive drugs, this notion require additional correction of antihypertensive therapy.

The aim. To analyze current evidence about etiology, pathogenesis, clinical manifestation, diagnosis, and treatment of patients with COVID-19 associated myocarditis. Multisystem inflammatory syndrome is possible in COVID-19 including inflammatory damage to the myocardium, which may last over several months and worsen the disease outcome. Mechanisms of inflammatory cardiac damage include direct damage by SARS-CoV-2, massive release of cytokines, dysregulation of the renin-angiotensin system. All these factors can aggravate pre-existing overload of the right heart chambers in patients with multifocal pneumonia, thrombosis of coronary arteries and myocardial ischemia. Inflammation of the myocardium manifests with typical symptoms of myocarditis and pericarditis. It can be accompanied by heart failure with rapid decompensation, arrhythmia, acute coronary syndrome or even sudden death. Laboratory findings in COVID-19 associated myocarditis include high levels of CRP, BNP, NT-proBNP, and D-dimer. Transthoracic echocardiography allows for an assessment of the left ventricular dysfunction and diagnosis of a pericardial effusion. Heart MRI according to the Lake Louise Diagnostic Criteria is the most sensitive diagnostic method in acute myocarditis. Medical imaging is indicated only in cases when results obtained can potentially influence the patient management tactics and should be performed according to the shortest protocol due to high risks of virus transmission. Conclusions. ESC experts (2020) do not provide unanimous recommendations for the treatment of SARS-CoV-2 associated myocarditis, considering a lack of the evidence base. Patient management is limited to adequate treatment of heart failure, arrhythmia, acute coronary syndrome, and prevention of thrombotic complications. Ongoing studies are aiming to evaluate potential place of glucocorticoids, intravenous immunoglobulins, antibodies against IL-6 receptor, colchicine in the treatment of COVID-19.

Cardiac arrhythmias in patients with COVID-19 infection may be due to many pathophysiological factors. Further study on the structure of arrhythmias in this category of patients will reveal clinically significant arrhythmias and select the optimal management. The aim: to determine the features of arrhythmias in patients with and without concomitant cardiovascular disease who suffered from COVID-19 infection based on the results of 24-hour electrocardiogram (ECG) monitoring. Materials and methods. 84 patients (45 men – 53.5 %, 39 women – 46.5 %) who had COVID-19 infection over 12 weeks previously were examined. Patients were divided into 2 groups – with and without a history of concomitant cardiovascular disease. The patient groups did not differ in age (P = 0.33) and sex (P = 0.58, P = 0.64). 24-hour ECG monitoring was performed on a Cardiosens K device (XAI-MEDICA, Kharkiv) according to the standard method. Results. Comparison of 12-channel ECG data did not reveal a significant difference in the incidence of single atrial (P = 0.13) and ventricular extrasystoles (P = 0.37) between the two groups, but sinus tachycardia was significantly more common in patients without concomitant cardiovascular disease (P = 0.022). According to 24-hour ECG monitoring, a significantly higher total number of arrhythmias, in particular, supraventricular extrasystoles (P = 0.009), high gradations of ventricular arrhythmias: paired ventricular extrasystoles (P = 0.041), ventricular bigeminy (P = 0.005), ventricular trigeminy (P = 0.004), ventricular salvos (P = 0.017) were detected significantly more frequently in patients with concomitant cardiovascular disease after COVID-19 infection than those in the comparison group. The results of 24-hour ECG monitoring also showed that patients without cardiovascular disease were significantly more likely to have inappropriate sinus tachycardia (P = 0.03) and postural orthostatic tachycardia (P = 0.04). Paroxysmal arrhythmias were significantly more common in patients with concomitant cardiovascular pathology, namely unstable (P = 0.002) and stable paroxysms of atrial tachycardia (P = 0.014), unstable paroxysms of monomorphic ventricular tachycardia (8.3 %), paroxysms of atrial fibrillation (6.2 %). Conclusions. 24-hour ECG monitoring should be advised in patients with COVID-19 infection and concomitant cardiovascular disease in addition to recording a standard 12-channel ECG to detect prognostically unfavorable cardiac arrhythmias, possible arrhythmogenic manifestations of post-COVID-19 syndrome and choose management tactics for these patients.

The article considers the results of analysis of the personality psychological type of patients with resistant arterial hypertension in the formation of adherence to treatment for the purpose of effective blood pressure control by a doctor and a patient. Obtained data is demonstrated that the overwhelming majority of both adherent and non-adherent patients are characterized by "adaptive" types of attitude to disease (harmonic, ergopathic, anosognostic), that is, types without impairment of mental and social adaptation. Non-adherent patients more often have types of attitude to disease, such as apathetic, melancholic, mixed ergopathic and hypochondriac-sensitive types, which were characterized by indifference to their illness, depressed mood, fear of becoming a burden to relatives, a fear of side effects of medication, which in general may contribute to patients' non-adherence to treatment. Adherent patients more often have types of attitude to disease, such as harmonic, ergopathic, anosognostic and mixed ergopathic-anosognostic types, which indicated the 197 patient's desire to save working capacity and unwillingness to assume the role of "patient". The motivation for active continuation of treatment in such patients may be the desire to return to a full-fledged lifestyle, to maintain their ability to work, which in general can contribute to the patient's adherence to treatment.

In an experiment on white rats with toxic nephritis, pathological changes in the structural and functional state of the kidneys were determined. An increase in the daily diuresis (p <0.001) was found, due to an increase in the glomerular filtration rate by (p <0.001) and a significant decrease in the percentage of fluid back-suction (p <0.001). The excretion of creatinine and urea increased by (p <0.01), and the excretion of chloride ions, on the contrary, decreased (p <0.01). Application on the background of the development of lowmineralized silicon chloride-hydrocarbonate sodium water leads to partial