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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.
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.
"Это был обычный день, холодное утро. Я спал после ночного дежурства и проснулся от того, что начался массированный обстрел. На нас вышло танковое подразделение в количестве 16 танков. На моих глазах был подбит наш БТР и я побежал помогать вытаскивать ребят, но не Добежал немного, оставалось около семи метров, было слышно свист снарядов, взрывы и тьма... Я протер глаза от земли и увидел, что на месте руки голая кость, подумал, что надо посмотреть, что там с ногами, смогу ли передвигаться .Увидел, что нога была сильно разбита. Я думал, что я погибну, но лежал, понял, что долго не умираю, что буду жить и надо что-то делать, и наложил турникет", - говорит военный.
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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