Пульс - медицинский центр 
Пульс - медицинский центр
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When transitioning to biological therapy, subcutaneous administration should be considered to limit patient contact with the healthcare facility. Selective switching from intravenous infliximab to subcutaneous anti-TNF is not recommended as it may increase the risk of relapse. If the patient is in contact with a COVID-19 person, withdrawal of anti-TNF therapy for 2 weeks should be considered.
The use of thiopurine (azathioprine and mercaptopurine) reduces the immune response to viruses, which is associated with an increased risk of opportunistic infections. There is limited evidence that they increase the risk of respiratory infections. The risks and benefits should be considered, but most patients can continue on a stable dose. In patients in stable remission, elderly patients and in the presence of concomitant pathology, it is recommended to stop taking thiopurine. During a pandemic, it is recommended to avoid starting thiopurine or increasing the dose, which will allow patients to avoid potential side effects. If the patient is in contact with a COVID-19 person, temporary withdrawal of thiopurine for 2 weeks should be considered. If a patient tests positive for SARS-CoV-2 and/or develops COVID-19, temporary discontinuation of thiopurine may be recommended until the patient clears the infection.
Considering that a similar picture took place in previous years, in Ukraine there was an accumulation of a layer susceptible to poliomyelitis among the child population. In addition, since April 2016, the oral (live) polio vaccine (OPV), which is used in Ukraine, since the 3rd vaccination, does not contain type 2 poliovirus (two-component OPV, which is now used worldwide, contains only polioviruses). ). type ov1 and 3). This also contributes to a decrease in both individual and population immunity to type 2 poliovirus. The result was an outbreak of poliomyelitis caused by vaccine-derived type 2 poliovirus (a vaccine-derived virus that acquired neurovirulent properties during circulation in a low immune population.). There was no adequate response to this outbreak, namely additional vaccination rounds for children under 6 years of age to stop the circulation of the vaccine-related virus. In January 2022, a new outbreak emerged.
Имеющаяся пандемия COVID-19, вызванная SARS-CoV-2, приобрела масштабы чрезвычайного положения в области мирового здравоохранения. Лечение хронических воспалительных заболеваний кишечника (ХЗОК) согласно стандартам включает применение препаратов 5-аминосалициловой кислоты (5-АСК), кортикостероидов, цитостатиков, а также биологическую терапию. Однако эти методы лечения могут ослабить иммунную систему, которая потенциально подвергает пациентов с ХОЗК повышенному риску инфекций и инфекционных заболеваний, включая COVID-19. Следовательно, пациенты с ХОККом имеют больший риск развития COVID-19 и более тяжелого клинического течения, или даже смерти, по сравнению с населением в целом.
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