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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.
Більшість людей з високим тиском не мають ознак або симптомів, навіть якщо показники артеріального тиску досягають небезпечно високих рівнів. В той час деякі люди в разі підвищення тиску можуть мати головний біль, задишку або носові кровотечі. Але ці ознаки і симптоми не є специфічними і зазвичай не проявляються, поки тиск не досягне важкого або небезпечного для життя рівня.
The most common diseases associated with hypertension include: obesity, primarily abdominal obesity (AO), type 2 diabetes mellitus (DM), coronary heart disease (CHD), arrhythmias and conduction disorders, chronic kidney disease (CKD), cerebrovascular diseases , joint diseases, chronic obstructive pulmonary disease, sleep apnea syndrome, thyroid disease and other endocrine diseases. In this regard, the 2018 European Society of Hypertension and European Society of Cardiology guidelines emphasized the need for careful stratification of cardiovascular and overall risk of complications in order to select the most optimal antihypertensive therapy.
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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