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A separate problem is the treatment of hypertension in patients with COVID-19. The presence of a history of hypertension in patients with COVID-19 was associated with a more severe course of infection, in contrast to patients who did not have hypertension. According to modern concepts, during the COVID-19 pandemic, patients with hypertension should carefully monitor their blood pressure levels and take constantly prescribed medications. This also applies to the use of so-called blockers of the renin-angiotensin system for the treatment of patients with hypertension: angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. A number of recent studies show that these groups of drugs not only do not increase the risk of infection with the virus, but also significantly improve the course of coronavirus disease.
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.
It is the transition to the use of IPV in Ukraine for all doses of the Immunization Schedule that should be the next task for vaccination. For this, several mechanisms can be used, including humanitarian assistance, the conclusion of planned direct contracts with vaccine manufacturers based on the needs of the required composition of vaccines according to the Calendar, in particular, taking into account the existence of modern combined vaccines with IPV, which can also be used at an older age. In the absence of combination vaccines with IPV, IPV can be used as a single vaccine.
Отдельной проблемой является лечение АГ у больных COVID-19. Наличие в анамнезе АГ у пациентов с COVID-19 ассоциировалось с более тяжелым течением инфекции в отличие от больных, у которых гипертензия отсутствовала. По современным представлениям в период пандемии COVID-19 больные АГ должны тщательнее следить за уровнем своего АД и принимать постоянно рекомендованные врачом препараты. Это касается и применения для лечения больных АГ так называемых блокаторов ренин-ангиотензиновой системы: ингибиторов ангиотензин-превращающего фермента и блокаторов рецепторов ангиотензина II. Целый ряд проведенных в последнее время исследований, что указанные группы препаратов не только не повышают риск инфицирования вирусом, но и достоверно улучшают течение коронавирусной болезни.
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