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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.
Regardless of the period of the life cycle, it is necessary to increase self-esteem of health by optimizing the social environment, introducing the basics of a healthy lifestyle (in particular, various forms of self-realization, regular physical education and sports of optimal intensity, fitness, yoga, etc.). After all, inadequate self-assessment of one's own health can change a person's behavior in a negative direction, lead to the health of destructive or deviant forms of behavior.
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.
In regions where there are no active hostilities, it is necessary to intensify the process of polio vaccination of both local and displaced children under 6 years of age with an additional dose of inactivated vaccine and continue vaccination by age in accordance with the Immunization Schedule against all infectious diseases controlled by specific means. For the prevention of poliomyelitis, preference should be given to an inactivated vaccine for all
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