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Skin lesions in coronavirus infection caused by the SARS-CoV-2 virus are divided into seven categories. The first category includes skin angiitis caused directly by COVID-19 infection, against which the walls of small vessels of the dermis are damaged by immune complexes circulating in the blood. Angiitis is localized on the skin of the upper and lower extremities. They look like frostbite, painful, itchy. Such manifestations usually occur in young patients with a mild course of the disease, appear in the late stages and last about 12 days. The second category includes papular-vesicular rashes, which are characterized by acute clinical manifestations in the form of chickenpox, more similar to prickly heat, occurring against a background of high fever and increased sweating.
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.
Анализируя субъективную оценку здоровья студенческой молодежью (в возрасте до 25 лет) нами было установлено следующее: подавляющее большинство респондентов независимо от пола оценили собственное здоровье как «хорошо» и «очень хорошо». Критерий оценки «отлично» здоровья отмечали почти половина парней и каждая пятая девушка. Около 2% парней и 3% девушек отметили, что имеют «отличное» здоровье. Критерии оценки здоровья «посредственное» и «плохое» у ребят практически не отличались. Так, «посредственное» здоровье отмечено у 15% парней и у 14% девушек; «плохое» – у 2% парней и у 2% девушек.
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.
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