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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.
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.
Еще в 2002 г. по обоснованию Института в Календарь прививок Украины была введена инактивированная полиомиелитная вакцина (ИПВ) для 1-й прививки против полиомиелита (остальные 5 доз по возрасту дети продолжали получать ОПВ). В 2006 г. – эту вакцину начали применять и для второй прививки. Это позволило сначала снизить, а затем практически прекратить случаи вакциноассоциированного паралитического полиомиелита в Украине. С тех пор неоднократно поднимался вопрос перехода в Украину на полную схему вакцинации ИПВ, как это практикуется уже много лет во всех странах Европы, США, Канаде, Австралии. В настоящее время эта проблема приобретает еще большую актуальность, учитывая как эпидемическую ситуацию, так и перспективы вступления Украины в ЕС.
Moreover, low vitamin D levels common in patients with CVD may increase the risk and severity of COVID-19. This is because vitamin D increases levels of anti-inflammatory cytokines and reduces viral replication, which in turn can reduce pro-inflammatory cytokines that contribute to lung damage. Despite the lack of evidence demonstrating increased susceptibility to COVID-19, drugs used in the treatment of COPD increase the risk of respiratory tract infections to varying degrees. However, theoretically, some immunosuppressive drugs may have beneficial effects, given that the cause of death in COVID-19 is a cytokine storm leading to acute respiratory failure.
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