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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.
"На тот момент я считал, что лучше уж смерть, чем быть без конечностей. Был такой случай, что я получил гранату, хотел взорвать себя, сказал товарищам, чтобы отошли, но они сказали: "Нет, если у тебя есть желание, давай вместе с нами". И я ее спрятал. Товарищи меня спасли, тащили через ад. Я им много раз говорил, оставьте меня, где-то среди домов, вернитесь, если я буду жив. Но они сказали, что мы тебя не оставим и тянули. Возле нас разрывались снаряды, а они не испугались, вовремя меня дотянули. Я благодарен товарищам и не имею права их подвести. Должен жить дальше, чтобы они не зря рисковали своей жизнью", - говорит Михаил Юрчук.
Analyzing the subjective assessment of health by student youth (under the age of 25), we found the following: the vast majority of respondents, regardless of gender, rated their own health as "good" and "very good". Almost half of the guys and every fifth girl noted the criterion for assessing "excellent" health. About 2% of boys and 3% of girls noted that they have “excellent” health. The criteria for assessing the health of "mediocre" and "poor" for the children practically did not differ. Thus, “mediocre” health was observed in 15% of boys and 14% of girls; "bad" - 2% of boys and 2% of girls.
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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