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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.
Именно переход на использование в Украине ИПВ для всех доз Календаря прививок должен быть ближайшей задачей по вакцинопрофилактике. Для этого можно использовать несколько механизмов, включая гуманитарную помощь, заключение планируемых прямых договоров с производителями вакцин исходя из потребностей необходимого состава вакцин согласно Календарю, в частности с учетом существования современных комбинированных вакцин с ИПВ, которые могут быть использованы и в более старшем возрасте. При отсутствии комбинированных вакцин с ИПВ можно использовать ИПВ в качестве моновакцины.
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.
The occurrence and course of hypertension is closely related to the presence of its modified and unmodified risk factors: heredity, psychoemotional stress, smoking, unbalanced diet (excessive salt, saturated fat intake), excessive alcohol consumption, overweight and sedentary lifestyle.
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