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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.
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.
"Это был обычный день, холодное утро. Я спал после ночного дежурства и проснулся от того, что начался массированный обстрел. На нас вышло танковое подразделение в количестве 16 танков. На моих глазах был подбит наш БТР и я побежал помогать вытаскивать ребят, но не Добежал немного, оставалось около семи метров, было слышно свист снарядов, взрывы и тьма... Я протер глаза от земли и увидел, что на месте руки голая кость, подумал, что надо посмотреть, что там с ногами, смогу ли передвигаться .Увидел, что нога была сильно разбита. Я думал, что я погибну, но лежал, понял, что долго не умираю, что буду жить и надо что-то делать, и наложил турникет", - говорит военный.
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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