Possible interconnection between irational doping, veterinary medication, and pathomorphological changes in the iliac artery segment in population of cyclists who have infected and recovered from Covid-19 disease
Authors: Solakovic Sid , Serhatlic Haris , Stojanovic Dejan , Stojanovic Mirela , Stojanovic Sara , Solakovic Nina , Hajrulahovic Fedja , Pavlović Ratko , Vrcić Mensur , Alexe Dan , Kozina Zhanneta , Demirci Nevzat 
Published: October 2024

Introduction: Doping which includes veterinary drugs as irrational human medicine after the infection with COVID 19 still leaves the field open from the aspect of vascular surgery and angiology of the iliac segment. Reflection of the effect of the COVID 19 virus on the sports performance of athletes in various sports after the corona virus is still present. Some athletes have had a hard time individually coping with the clinical consequences after a long illness of the COVID 19 virus. Even though covert doping is part of the everyday life of an elite athlete, it still remains an unresolved topic in the form of a solution for post-COVID 19 symptoms or switching to or taking some other masked substances that are impossible to detect in the blood, as well as a potential reflection on the morphological changes of the arteries. Although consequences of the corona virus for the cardiorespiratory system have been reported, a question arises as to the connection between the development of iliac syndrome and pathomorphological arterial iliac changes in athletes with suspicion of potential correlation with underground doping substances of pharmacologically untested origin in the Balkan population. Widespread global COVID 19 pandemic and the isolation factor have forced numerous athletes to switch their normal training routine and protocols to alternatives such as cycling with or without abusing illegal substance. Increased intima-media thickness, the first structural change detected in atherosclerosis, is an important surrogate marker in atherosclerosis can be connected with high intensity endurance cyclists, running and triathlon competitive athletes affecting their poor performance status and professional doping levels. In some cases, amateur and recreational athletes are also affected especially if they were exposed to COVID 19 infection and doping. Goals: The primary focus of the present study is to determine the initial progression of the disease during and after the COVID 19 pandemic, starting from morphological changes and obstructive arteriopathy of the external iliac artery on account of measuring intima media thickness and the possibility of outset of kinking and obstructive arterial disease of the external iliac artery after 3 years. The secondary focus of the study is to examine the influence of doping on the pathomorphological changes of the external iliac artery during 3 years of research. Subjects and Methods: two groups of were observed (recreational and amateur cyclist). In total 63 selected subjects in the demographic area of ​​former Yugoslavia without cardiovascular disease were observed during the January 2021 and January 2024 period (3 years). Results: Changes in intima-media thickness of iliac artery from baseline 3 years were observed between the standard exercise amateur group and recreational control group. However, intensity exercise under 9000km per year were no significant developing progression of intima-media thickness of iliac artery during 3 years in recreational control group, but minimal progression of intima-media thickness of iliac artery were significant in amateur cycling group due to the potential effect of doping. Conclusion: The application of doping itself is indisputable, but the missing link that would confirm this claim is scientifically limited. We cannot confirm with certainty what is the trigger for the progression of pathomorphological changes and whether the consequences of overcoming the COVID 19 infection or doping. But there are many scientific facts and studies that confirm the connection between progressive atherosclerosis and illegal underground doping substances of pharmacologically untested origin. The consequences may result with a tendency for a futuristic vascular invasive patch or bypass surgical treatment.