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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.
“For the second month, we see an increase in the number of coronavirus diseases. Over the past week, 24,000 new cases were recorded, the week before that there were 16,000, that is, there is a gradual increase. Our experts, together with WHO experts, predict that this year the peak incidence will be at the beginning October... In previous years, it was the end of October - the beginning of November. We are preparing for this in order to provide proper medical care," the minister said.
Если пациент находится в контакте с человеком COVID-19, необходимо рассмотреть возможность временного отказа от приема тофацитиниба в течение 2 недель. Если у пациента положительный результат теста на SARS-CoV-2 и/или у него развивается COVID-19, необходимо рассмотреть возможность отказа от приема тофацитиниба до тех пор, пока пациент не избавится от инфекции.
A separate problem is the treatment of hypertension in patients with COVID-19. The presence of a history of hypertension in patients with COVID-19 was associated with a more severe course of infection, in contrast to patients who did not have hypertension. According to modern concepts, during the COVID-19 pandemic, patients with hypertension should carefully monitor their blood pressure levels and take constantly prescribed medications. This also applies to the use of so-called blockers of the renin-angiotensin system for the treatment of patients with hypertension: angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. A number of recent studies show that these groups of drugs not only do not increase the risk of infection with the virus, but also significantly improve the course of coronavirus disease.
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