Пульс - медицинский центр 
Пульс - медицинский центр
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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.
Experts refer to the third category of skin manifestations as pink lichen and papulosquamous rashes, which are infectious-allergic skin lesions associated with COVID-19 infection. The clinical feature of pink lichen in this case is the absence of maternal plaque. The fourth category includes a measles rash. To the fifth - toxicodermia. This rash is associated with individual intolerance of patients of certain groups of drugs. The sixth category of skin manifestations of coronavirus infection, scientists include urticaria, which in some cases may be a harbinger of the onset of COVID-19.
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.
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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