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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.
Отдельной проблемой является лечение АГ у больных COVID-19. Наличие в анамнезе АГ у пациентов с COVID-19 ассоциировалось с более тяжелым течением инфекции в отличие от больных, у которых гипертензия отсутствовала. По современным представлениям в период пандемии COVID-19 больные АГ должны тщательнее следить за уровнем своего АД и принимать постоянно рекомендованные врачом препараты. Это касается и применения для лечения больных АГ так называемых блокаторов ренин-ангиотензиновой системы: ингибиторов ангиотензин-превращающего фермента и блокаторов рецепторов ангиотензина II. Целый ряд проведенных в последнее время исследований, что указанные группы препаратов не только не повышают риск инфицирования вирусом, но и достоверно улучшают течение коронавирусной болезни.
Mikhail Yurchuk is from the Khmelnytsky region. After school, the man worked at a glass factory and a furniture factory. However, at the age of 26, he decided to become a professional military man. “Since childhood, I have dreamed of becoming a military man. For me, this is about honor, duty. First, I served in a missile brigade, I was a rocket scientist, then I went to a military college for non-commissioned officers and finally went to the airborne brigade,” says Mikhail Yurchuk. When a full-scale war began, the military served in the Donbass. Then the brigade was moved to the Kharkov region. Michael was wounded there.
The first and mandatory step in the treatment of hypertension is lifestyle modification (LS), which is aimed at correcting the above risk factors, primarily modifiable ones. A big problem is the choice of the most optimal treatment for hypertension, which can slow down the progression of lesions of the heart, blood vessels, kidneys, brain and eyes. The vast majority of hypertensive patients who seek medical help require combination antihypertensive therapy. At the same time, the most appropriate at the present level is the use of fixed combinations of such drugs.
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