Пульс - медицинский центр 
Пульс - медицинский центр
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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.
Treatment with corticosteroids (especially prednisolone ≥20 mg/day or equivalent) is associated with an increased risk of infection. However, it is unclear whether corticosteroid therapy is associated with an increased risk of developing COVID-19 or its complications. Data on budesonide, a topical corticosteroid with low systemic bioavailability, show that these drugs are associated with significantly fewer side effects compared to systemic corticosteroids and their side effects are close to placebo. If possible, corticosteroids should be avoided and a rapid dose reduction considered, and a switch to budesonide is recommended. This must be taken into account, taking into account the risk of exacerbation of CKD. If a patient with COPD is in contact with a person with COVID-19 or develops COVID-19, it is recommended to gradually reduce the dose of corticosteroids, the use of budesonide is preferred, but taking into account the severity of COPD and the risk of exacerbation.
Thus, hypertension has been and remains a very important medical and social problem that requires appropriate attention not only from healthcare institutions and medical workers, but also from the leadership of the Ministry of Health and the state. Only through the joint efforts of representatives of medical science, health care and the entire public society can it be possible to achieve an increase in the effectiveness of the fight against this disease
In regions where there are no active hostilities, it is necessary to intensify the process of polio vaccination of both local and displaced children under 6 years of age with an additional dose of inactivated vaccine and continue vaccination by age in accordance with the Immunization Schedule against all infectious diseases controlled by specific means. For the prevention of poliomyelitis, preference should be given to an inactivated vaccine for all
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