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The current COVID-19 pandemic caused by SARS-CoV-2 has become a global health emergency. Treatment of chronic inflammatory bowel disease (CIBD) according to the standards includes the use of 5-aminosalicylic acid (5-ASA), corticosteroids, cytostatics, and biological therapy. However, these treatments can weaken the immune system, which potentially puts COPD patients at increased risk of infections and infectious diseases, including COVID-19. Therefore, patients with CVD have a greater risk of developing COVID-19 and more severe clinical course, or even death, compared to the general population.
In the age group of 44-60 years, 47% of men and 66% of women rated their own health as "good" (p<0.05). A feature of the self-assessment of health of the respondents of this age group was higher levels of subjective assessment of health in women compared to men: about 2% of women subjectively assessed their own health as "excellent"; the proportion of women who rated their health as "mediocre" was two times less compared to men (32% versus 17%; p<0.05). In the group of older people (over 61 years of age), gender characteristics of the distribution of self-assessment of health by respondents were also established. Thus, half of the men surveyed rated their own health as “good”, which was three times more than women (53% versus 18%, p<0.01). In women, on the contrary, the share of those who rated their own health as “mediocre” was 17% higher. Almost every fifth woman of this age considers her own health to be “bad”, while not a single man gave such an assessment. High health scores (“excellent” and “very good”) were absent for both men and women.
При возможности следует избегать применения кортикостероидов и рассмотреть возможность быстрого снижения дозы и рекомендуется перейти на будесонид . Это необходимо учесть с учетом риска обострения ХЗОК. Если пациент с ХОЗК находится в контакте с человеком с COVID-19 или у него развивается COVID-19, рекомендуется постепенно снизить дозу кортикостероидов, предпочтение отдается применению будесонида , но с учетом тяжести течения ХОЗК и риска развития обострения.
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.
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