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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.

Mikhail Yurchuk is from the Khmelnytsky region. After school, the man worked at a glass factory and a furniture factory. However, at the age of 26, he decided to become a professional military man. “Since childhood, I have dreamed of becoming a military man. For me, this is about honor, duty. First, I served in a missile brigade, I was a rocket scientist, then I went to a military college for non-commissioned officers and finally went to the airborne brigade,” says Mikhail Yurchuk. When a full-scale war began, the military served in the Donbass. Then the brigade was moved to the Kharkov region. Michael was wounded there.

По его словам, сейчас в больницах находится 5,5 тысячи пациентов, которым установлен диагноз коронавирусная болезнь. Из них 2300 человек находятся на кроватях, к которым подведена кислородная терапия, и большинство из них ее получают. Для предотвращения логистических проблем, еще в конце прошлого года, было выделено госфинансирование по нескольким механизмам: один в виде централизованных закупок, один в виде субвенций, предоставленных регионам для того, чтобы закупить автономные источники поставок кислорода. 15 сентября Министерство здравоохранения направило в регионы 124 608 упаковок препарата от коронавирусной болезни "Пакскловид". Лекарство назначается в первую очередь пациентам из групп риска, чтобы предотвратить сложное течение коронавирусной болезни.

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.

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