Пульс - медицинский центр 
Пульс - медицинский центр
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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.
On March 11, 2020, the World Health Organization declared the novel severe respiratory syndrome coronavirus (SARS-CoV-2) a pandemic. The number of cases worldwide is constantly growing, the infection is a serious threat to health, especially in the case of old age, immunodeficiency and the presence of concomitant diseases. There are now a growing number of reports and preliminary observations indicating that the COVID-19 virus can also infect the skin. Skin lesions ranging from "covid fingers" to hives can be potential signs of coronavirus. The flow of information about the skin manifestations of coronavirus infection prompts the development of a classification of these lesions.
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.
Независимо от периода жизненного цикла, необходимо повышать самооценку здоровья путем оптимизации социальной среды, введения основ здорового образа жизни (в частности, разные формы самореализации, регулярные занятия физической культурой и спортом оптимальной интенсивности, фитнесс, йога и т.д.). Ведь неадекватная самооценка собственного здоровья может изменить поведение человека в негативную сторону, привести к здоровью разрушительных или девиантных форм поведения.
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