Remodeling of the brachiocephalic arteries on the background of arterial hypertension in electric train drivers who have been ill with COVID-19
Authors: Gerasimidi Sofiya K. , Glukhov Dmitrij V. 
Published: December 2024

Over the more than three-year period of the coronavirus pandemic, researchers have identified the relationship between cardiovascular diseases and the severity of coronavirus infection, especially in people who have had COVID-19 in a hospital setting. One of the complications of patients with coronavirus infection is an increase in blood pressure, which can lead to the formation of hypertension. It is known that arterial hypertension occupies a leading position among workers in the transport sector, including electric train drivers, in our country. The cardiovascular system of machinists is influenced by industrial risk factors (noise, vibration, psycho-emotional stress, etc.) and often non-industrial: smoking, increased body weight. The combination of these factors: coronavirus infection, industrial and non-industrial risk factors can accelerate the development of cardiovascular diseases in electric train drivers.
The study aims are the results of duplex scanning of brachiocephalic arteries in electric train drivers who have been ill with various forms of new coronavirus infection.
The authors have conducted the study on an outpatient basis among 12 male machinists aged 43.4±5.0 years working in the Central Federal District, who who have been ill with COVID-19 in the first and second quarters of 2021, and are currently continuing their work as an "electric train driver". The subjects were divided into 2 groups: the 1st group consisted of workers who had suffered a mild form of COVID-19, the 2nd group consisted of workers who had suffered a severe form of COVID-19. Scientists conducted duplex scanning of brachiocephalic arteries with color Doppler mapping for workers, and they also studied outpatient charts of workers, analyzed blood pressure data. The research was conducted in the period 2022–2023. The employees involved in the studies had risk factors such as smoking, increased body weight and high blood pressure.
Scientists have revealed higher blood pressure indicators in workers of the 2nd group (severe form), in contrast to the indicators of the 1st group (mild form), while both groups had "grade I arterial hypertension". Ultrasound examination of the brachiocephalic arteries in group 2 workers, unlike group 1 workers, revealed the initial signs of vascular remodeling at the extracranial level in the form of a diffuse increase in the echogenicity of the intima-media complex and its thickening to 1 mm in the common carotid artery, deformations of the common and internal carotid arteries, in the form of wavy C-S‑shaped tortuosity, initial ectasia of the common carotid arteries, a decrease in linear indicators of blood flow velocity, an increase in the resistance index. And also in workers who have had a severe form of coronavirus infection, when visualizing the vertebral arteries, an indirect linear course in the interosseous canal is traced, which is not observed in workers who have had a mild form of COVID-19. A study of the middle cerebral artery at the intracranial level in group 1 workers indicates the absence of hemodynamic changes, and in group 2 workers there was a decrease in speed indicators and an increase in the resistance index.
In the machinists who suffered both severe and mild forms of COVID-19, scientists established "grade I arterial hypertension", which required the appointment of antihypertensive therapy. In workers who have undergone severe COVID-19, blood pressure indicators are higher, which led to remodeling of the brachiocephalic arteries in the form of thickening of the intima-media complex of the common carotid artery, minor ectasia and the development of deformities of the carotid arteries, increased resistance to blood flow, which is not present in workers who have undergone a mild form. Workers who have developed complications in the post-СOVID period need annual duplex scanning with color Doppler mapping of the brachiocephalic arteries, which will help identify abnormalities at the extra- and intracranial level.
Limitations. There are quantitative limitations due to the number of COVID-19 patients.
Ethics. The study was approved by the local Ethics Committee of the Izmerov Research Institute of Occupational Health (Protocol No.1 dated February 16, 2022).