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At present, the risk of increased circulation of vaccine-related polioviruses and associated outbreaks with a low level of vaccination coverage against the background of the use of an oral vaccine is also complicated by military operations in the country, leading to the destruction of the infrastructure of cities and towns, intensive migration and evacuation of the population. Ukraine, and to regions where there are no active hostilities (Chernivtsi, Transcarpathian, Lvov, Volyn regions). These areas were the ones with the lowest polio vaccination rates in 2021.

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.

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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При переходе к биологической терапии необходимо рассмотреть возможность подкожного введения, чтобы ограничить контакт пациента с медицинским учреждением. Выборочный переход от внутривенных инфузий инфликсимаба к препаратам анти-TNF с подкожным введением не рекомендуется, поскольку это может увеличить риск рецидива. Если пациент находится в контакте с человеком COVID-19, необходимо рассмотреть возможность отказа от терапии анти-TNF в течение 2 недель. Если у пациента положительный результат теста на SARS-CoV-2 и/или у него развивается COVID-19, необходимо рассмотреть возможность отказа от биопрепаратов до тех пор пока пациент не избавится от инфекции.


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