г. Казань,
ул.Сокола, д.3

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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.

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Skin lesions in coronavirus infection caused by the SARS-CoV-2 virus are divided into seven categories. The first category includes skin angiitis caused directly by COVID-19 infection, against which the walls of small vessels of the dermis are damaged by immune complexes circulating in the blood. Angiitis is localized on the skin of the upper and lower extremities. They look like frostbite, painful, itchy. Such manifestations usually occur in young patients with a mild course of the disease, appear in the late stages and last about 12 days. The second category includes papular-vesicular rashes, which are characterized by acute clinical manifestations in the form of chickenpox, more similar to prickly heat, occurring against a background of high fever and increased sweating.

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Even more than the material, the physician needs a technique based on clear communication and standard step-by-step practice. This refutes the opinion that the successful result of the restoration of the anterior teeth is primarily a consequence of the aesthetic and artistic talent of a particular doctor. This attitude leads to improvisations, for example, to imitation of natural tissue directly during the treatment of the patient, and sometimes ends in disappointment. It is much more realistic to follow the well-known rational method, experimentally derived from more than 20 years of research and clinical trials. This method needs to be carefully studied; it requires patience, as well as exercises with artificial and extracted teeth.

При переходе к биологической терапии необходимо рассмотреть возможность подкожного введения, чтобы ограничить контакт пациента с медицинским учреждением. Выборочный переход от внутривенных инфузий инфликсимаба к препаратам анти-TNF с подкожным введением не рекомендуется, поскольку это может увеличить риск рецидива. Если пациент находится в контакте с человеком COVID-19, необходимо рассмотреть возможность отказа от терапии анти-TNF в течение 2 недель. Если у пациента положительный результат теста на SARS-CoV-2 и/или у него развивается COVID-19, необходимо рассмотреть возможность отказа от биопрепаратов до тех пор пока пациент не избавится от инфекции.

Маджахедов  Иван Васильевич
Маджахедов
Иван Васильевич
Главный врач клиники, стоматолог-ортодонт, стоматолог-ортопед, стоматолог терапевт.
Зелень
Антон Игорович
Земляной
Алексей Викторович
Стоматолог-хирург, стоматолог-терапевт
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