Пульс - медицинский центр 
Пульс - медицинский центр
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Both patients and doctors should be well aware of the need for long-term therapy with periodic monitoring of key indicators and the obligatory achievement of the so-called target levels of blood pressure, that is, stable normalization of blood pressure. Only such an approach to the treatment of patients with hypertension can give a successful result. But at present, as mentioned above, only a very small number of patients with hypertension are treated effectively. In this regard, there is no decrease in the frequency of complications of this disease in Ukraine.
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.
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.
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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