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When transitioning to biological therapy, subcutaneous administration should be considered to limit patient contact with the healthcare facility. Selective switching from intravenous infliximab to subcutaneous anti-TNF is not recommended as it may increase the risk of relapse. If the patient is in contact with a COVID-19 person, withdrawal of anti-TNF therapy for 2 weeks should be considered.
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.
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
При возможности следует избегать применения кортикостероидов и рассмотреть возможность быстрого снижения дозы и рекомендуется перейти на будесонид . Это необходимо учесть с учетом риска обострения ХЗОК. Если пациент с ХОЗК находится в контакте с человеком с COVID-19 или у него развивается COVID-19, рекомендуется постепенно снизить дозу кортикостероидов, предпочтение отдается применению будесонида , но с учетом тяжести течения ХОЗК и риска развития обострения.
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