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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
In regions where there are no active hostilities, it is necessary to intensify the process of polio vaccination of both local and displaced children under 6 years of age with an additional dose of inactivated vaccine and continue vaccination by age in accordance with the Immunization Schedule against all infectious diseases controlled by specific means. For the prevention of poliomyelitis, preference should be given to an inactivated vaccine for all
К шестой категории кожных проявлений коронавирусной инфекции ученые относят крапивницу, которая в некоторых случаях может быть предвестником начала COVID-19 . К последней (седьмой) категории можно отнести артифициальные (трофические) изменения тканей лица, возникшие у пациентов с искусственной вентиляцией легких и из-за длительного лежания на животе. Приведенные классификации были первыми описаниями поражений кожи при COVID-19 и поэтому приводились разные признаки: те, что были вызваны именно COVID-19 , и те, которые возникали вследствие различных причин, в частности, связанных с лечением заболевания. В связи с тем, что эти поражения нуждались в различных подходах как в лечении, так и в проведении противоэпидемических или мер предосторожности, мы, исходя из опыта всех этих месяцев наблюдения за больными, предлагаем классификацию поражений кожи, ассоциированные с COVID-19 . выложить следующим образом
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.
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