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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.
"It was an ordinary day, a cold morning. I was sleeping after a night shift and woke up from the fact that massive shelling had begun. A tank unit of 16 tanks approached us. Our armored personnel carrier was shot down before my eyes and I ran to help pull the guys out, but did not I ran a little, there were about seven meters left, I could hear the whistle of shells, explosions and darkness ... I rubbed my eyes from the ground and saw that there was a bare bone in the place of the arm, I thought that I should see what was happening with my legs, if I could move. "I thought that I would die, but I was lying, I realized that I would not die for a long time, that I would live and I had to do something, and I put on a tourniquet," the military man says.
Back in 2002, according to the justification of the Institute, inactivated polio vaccine (IPV) was introduced into the Immunization Calendar of Ukraine for the 1st vaccination against poliomyelitis (children continued to receive OPV for the remaining 5 doses by age). In 2006, this vaccine was also used for the second vaccination. This made it possible to first reduce and then practically stop the cases of vaccine-associated paralytic poliomyelitis in Ukraine. Since then, the issue of switching to a full IPV vaccination scheme in Ukraine has been repeatedly raised, as has been practiced for many years in all European countries, the USA, Canada, and Australia. Currently, this problem is becoming even more urgent, given both the epidemic situation and the prospects for Ukraine's accession to the EU.
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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