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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.
The last (seventh) category includes artificial (trophic) changes in facial tissues that occurred in patients with artificial lung ventilation and due to prolonged lying on the stomach. The classifications given were the first descriptions of skin lesions in COVID-19 and therefore different signs were given: those that were caused specifically by COVID-19, and those that arose due to various causes, in particular those associated with the treatment of the disease. Due to the fact that these lesions required different approaches in both treatment and anti-epidemic or precautionary measures, we, based on the experience of all these months of observation of patients, propose a classification of skin lesions associated with COVID-19. lay out like this
So, at the population level, health is a multifactorial phenomenon that includes both an objective and a subjective component. Considering that low self-esteem of health is a factor influencing its formation in young people, their choice of risky behavior, propensity for bad habits and psychological disorders, it is important to take into account the subjective component of health in adolescents and young people. the purpose of early detection of certain deviations in self-esteem or the impact on the formation of health of adverse factors, the effect of which can be minimized.
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.
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