{"id":43857,"date":"2023-11-22T11:41:23","date_gmt":"2023-11-22T10:41:23","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=43857"},"modified":"2023-11-22T11:48:05","modified_gmt":"2023-11-22T10:48:05","slug":"lide-se-strevnimi-zanety-prozivaji-covid-19-a-ockovani-stejne-jako-zdravi","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=43857","title":{"rendered":"Lid\u00e9 se st\u0159evn\u00edmi z\u00e1n\u011bty pro\u017e\u00edvaj\u00ed covid-19 a o\u010dkov\u00e1n\u00ed stejn\u011b jako zdrav\u00ed"},"content":{"rendered":"\n<p><strong>Pacienti se st\u0159evn\u00edmi z\u00e1n\u011bty pro\u017e\u00edvaj\u00ed covid-19 a o\u010dkov\u00e1n\u00ed stejn\u011b jako zdrav\u00e1 populace. Dosud experti na tr\u00e1vic\u00ed trakt p\u0159edpokl\u00e1dali, \u017ee je tato skupina nemoc\u00ed v\u00edce ohro\u017eena a o\u010dkov\u00e1n\u00ed u nich nevytvo\u0159\u00ed tolik protil\u00e1tek jako o zdrav\u00fdch. Studie proveden\u00e1 K<\/strong><strong>linick\u00fdm a v\u00fdzkumn\u00fdm centrem pro st\u0159evn\u00ed z\u00e1n\u011bty<\/strong><strong>ISCARE, kterou nyn\u00ed publikoval presti\u017en\u00ed americk\u00fd \u010dasopis Inflammatory Bowel Disease, v\u0161ak tyto teorie zcela vyvrac\u00ed. Idiopatick\u00e9 st\u0159evn\u00ed z\u00e1n\u011bty (IBD), tedy p\u0159edev\u0161\u00edm Crohnovu chorobu a ulcer\u00f3zn\u00ed kolitidu, m\u00e1 v\u00a0\u010cesku asi 60\u00a0000 lid\u00ed. L\u00e9ka\u0159i odhaduj\u00ed, \u017ee do \u010dty\u0159 let \u010d\u00edslo vzroste a\u017e na 70\u00a0000.<\/strong><\/p>\n\n\n\n<p>\u201e<em>Sledovali jsme v\u00edce ne\u017e 600 pacient\u016f s&nbsp;IBD z\u00e1n\u011bty v&nbsp;souvislosti s&nbsp;n\u00e1kazou koronavirem a s o\u010dkov\u00e1n\u00edm a porovn\u00e1vali v\u00fdsledky se zdravou populac\u00ed. V\u016fbec poprv\u00e9 se tak nap\u0159\u00edklad prok\u00e1zalo, \u017ee pr\u016fb\u011bh n\u00e1kazy se u lid\u00ed se st\u0159evn\u00edmi z\u00e1n\u011bty nijak neli\u0161\u00ed od t\u011bch, kte\u0159\u00ed jsou zdrav\u00ed. A \u017ee o\u010dkov\u00e1n\u00ed vytv\u00e1\u0159\u00ed pacient\u016fm stejnou hladinu protil\u00e1tek jako t\u011bm, ji\u017e st\u0159evn\u00edmi z\u00e1n\u011bty netrp\u00ed. Pokud IBD pacienti nemoc prod\u011blaj\u00ed, reaguje jejich imunitn\u00ed syst\u00e9m l\u00e9pe ne\u017e u t\u011bch, jim\u017e se n\u00e1kaza vyhnula,\u201c<\/em> shrnul nejzaj\u00edmav\u011bj\u0161\u00ed v\u00fdsledky prof. MUDr. Milan Luk\u00e1\u0161, CSc., p\u0159ednosta kliniky a prim\u00e1\u0159 Klinick\u00e9ho a v\u00fdzkumn\u00e9ho centra pro st\u0159evn\u00ed z\u00e1n\u011bty ISCARE a prvn\u00ed m\u00edstop\u0159edseda \u010cesk\u00e9 gastroenterologick\u00e9 spole\u010dnosti (\u010cGS).<\/p>\n\n\n\n<p>Specialist\u00e9 se dosud ob\u00e1vali, \u017ee pacienti s&nbsp;autoimunitn\u00edmi chorobami, mezi n\u011b\u017e st\u0159evn\u00ed z\u00e1n\u011bty pat\u0159\u00ed, zareaguj\u00ed kv\u016fli sv\u00e9 nedob\u0159e funguj\u00edc\u00ed imunit\u011b na n\u00e1kazu h\u016f\u0159e a tak\u00e9 \u017ee si nevytvo\u0159\u00ed po o\u010dkov\u00e1n\u00ed proti covidu-19 dost protil\u00e1tek. <em>\u201eKdy\u017e jsme toti\u017e o\u010dkovali pacienty s&nbsp;IBD z\u00e1n\u011bty proti pneumokokovi nebo ch\u0159ipce, museli jsme jim d\u00e1vat v\u00edce d\u00e1vek, proto\u017ee zkr\u00e1tka nevytv\u00e1\u0159eli dost protil\u00e1tek. O to d\u016fle\u017eit\u011bj\u0161\u00ed je pozn\u00e1n\u00ed, \u017ee u vakc\u00edny proti covidu tomu tak nen\u00ed. Studie je pro n\u00e1s, specialisty, zlomov\u00e1,\u201c<\/em> vysv\u011btluje prof. Luk\u00e1\u0161. Informace, kter\u00e9 m\u011bli dosud \u010de\u0161t\u00ed specialist\u00e9 k&nbsp;dispozici ze zahrani\u010d\u00ed, byly podle experta na choroby tr\u00e1vic\u00edho traktu rozt\u0159\u00ed\u0161t\u011bn\u00e9.<\/p>\n\n\n\n<p>V\u00a0ISCARE sledovali reakce na o\u010dkov\u00e1n\u00ed proti covidu mRNA a vektorovou vakc\u00ednou u p\u0159esn\u011b 602 lid\u00ed se st\u0159evn\u00edmi z\u00e1n\u011bty. M\u011b\u0159ili jim protil\u00e1tky po 8 t\u00fddnech a pot\u00e9 znovu po 26 t\u00fddnech od dokon\u010den\u00e9 vakcinace a porovnali je se 170 zdrav\u00fdmi o\u010dkovan\u00fdmi. <em>\u201eHladina protil\u00e1tek a rychlost poklesu se v\u00a0obou skupin\u00e1ch nijak neli\u0161ila, i pro IBD pacienty tak plat\u00ed doporu\u010den\u00ed, \u017ee by se m\u011bli nechat o\u010dkovat t\u0159et\u00ed d\u00e1vkou,\u201c <\/em>pokra\u010duje prof. Luk\u00e1\u0161. Studie obecn\u011b prok\u00e1zala vy\u0161\u0161\u00ed hladinu protil\u00e1tek u t\u011bch, kte\u0159\u00ed dostali mRNA vakc\u00ednu. Potvrdila tak\u00e9, \u017ee l\u00e9ky na st\u0159evn\u00ed z\u00e1n\u011bty nijak neovliv\u0148uj\u00ed tvorbu protil\u00e1tek, a tak l\u00e9ka\u0159i nemus\u00ed sv\u00fdm pacient\u016fm s\u00a0IBD z\u00e1n\u011bty kv\u016fli covidu m\u011bnit ani p\u0159eru\u0161ovat ji\u017e zavedenou terapii. St\u0159evn\u00ed z\u00e1n\u011bty pat\u0159\u00ed mezi civiliza\u010dn\u00ed choroby a jen u Crohnovy choroby se za posledn\u00edch dvan\u00e1ct let zvedl po\u010det nemocn\u00fdch ze 14\u00a0000 na 27\u00a0000. <em>\u201eD\u016fvodem r\u016fstu v\u00fdskytu st\u0159evn\u00edch z\u00e1n\u011bt\u016f jsou d\u016fsledky zm\u011bn \u017eivotn\u00edho stylu, stravov\u00e1n\u00ed a \u017eivotn\u00edho prost\u0159ed\u00ed, kter\u00e9 n\u00e1s obklopuje.<\/em> <em>Zvy\u0161uje se spot\u0159eba antibiotik, kter\u00e9 prost\u0159ed\u00ed st\u0159eva \u2013 centr\u00e1ly ve\u0161ker\u00e9 imunity \u2013 neprosp\u00edvaj\u00ed. Stresujeme se mnohem v\u00edce a tak\u00e9 se stravujeme potravinami bohat\u00fdmi na r\u016fzn\u00e9 chemik\u00e1lie,\u201c<\/em> dod\u00e1v\u00e1 prof.\u00a0Luk\u00e1\u0161.<\/p>\n\n\n\n<p> St\u0159evn\u00ed z\u00e1n\u011bty postihuj\u00ed st\u00e1le \u010dast\u011bji mlad\u0161\u00ed ro\u010dn\u00edky \u2013 plat\u00ed to zejm\u00e9na u Crohnovy choroby, kde se obvykl\u00e9 v\u011bkov\u00e9 rozmez\u00ed pohybuje mezi 15 a 30 lety, ale v\u00a0posledn\u00edch letech nen\u00ed v\u00fdjimkou v\u00fdskyt u p\u0159ed\u0161koln\u00edch d\u011bt\u00ed a \u0161kol\u00e1k\u016f, asi u 15\u201320 %. \u010cast\u00fdm p\u0159\u00edznakem st\u0159evn\u00edch z\u00e1n\u011bt\u016f je krv\u00e1cen\u00ed z\u00a0kone\u010dn\u00edku, pr\u016fjmy, bolesti b\u0159icha, hubnut\u00ed nebo \u010dast\u00e9 nucen\u00ed na stolici. Pacient\u016fm pom\u00e1h\u00e1 p\u0159edev\u0161\u00edm biologick\u00e1 l\u00e9\u010dba. V\u00fdznamn\u00e9 zlep\u0161en\u00ed p\u00e9\u010de p\u0159edstavuje dle l\u00e9ka\u0159\u016f zaveden\u00ed biosimil\u00e1rn\u00edch biologik, kter\u00e9 sn\u00ed\u017eily n\u00e1klady na l\u00e9\u010dbu a zlep\u0161ily dostupnost terapie pro v\u0161echny pot\u0159ebn\u00e9 pacienty.<\/p>\n\n\n\n<p>Ke studii i k pravideln\u00fdm kontrol\u00e1m chronick\u00fdch pacient\u016f vyu\u017e\u00edvaj\u00ed l\u00e9ka\u0159i v&nbsp;ISCARE telemedic\u00ednu. <em>\u201e<\/em><em>Kontroly pacient\u016f prov\u00e1d\u00edme s&nbsp;pomoc\u00ed <\/em><em>webov\u00e9 aplikace,<\/em><em> tzv. IBD asistent, <\/em><em>p\u0159es ni\u017e lid\u00e9 se sv\u00fdm l\u00e9ka\u0159em komunikuj\u00ed, pos\u00edlaj\u00ed nam\u011b\u0159en\u00e9 hodnoty a vypl\u0148uj\u00ed dotazn\u00edky. Pacienti si syst\u00e9m pochvaluj\u00ed, \u0161et\u0159\u00ed toti\u017e \u010das a pen\u00edze za doj\u00ed\u017ed\u011bn\u00ed do centra \u2013 n\u011bkte\u0159\u00ed k n\u00e1m cestuj\u00ed z&nbsp;velk\u00e9 d\u00e1lky. L\u00e9ka\u0159 se jim paradoxn\u011b v\u011bnuje mnohem v\u00edce, ne\u017e kdy\u017e ho vid\u00ed jednou za dva m\u011bs\u00edce p\u0159i kontrole \u2013 on-line je s&nbsp;nimi v&nbsp;mnohem intenzivn\u011bj\u0161\u00edm styku<\/em><em>,\u201c <\/em>popisuje prof. Luk\u00e1\u0161 s&nbsp;t\u00edm, \u017ee virtu\u00e1ln\u00ed klinika umo\u017e\u0148uje pacientovi po\u017e\u00e1dat si o e-recept, \u017e\u00e1danku \u010di objedn\u00e1n\u00ed na vy\u0161et\u0159en\u00ed. Od ledna p\u0159\u00ed\u0161t\u00edho roku bude d\u00e1lkov\u00e9 monitorov\u00e1n\u00ed pomoc\u00ed telemedic\u00ednsk\u00fdch n\u00e1stroj\u016f platit zdravotn\u00ed poji\u0161\u0165ovna.<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Pacienti se st\u0159evn\u00edmi z\u00e1n\u011bty pro\u017e\u00edvaj\u00ed covid-19 a o\u010dkov\u00e1n\u00ed stejn\u011b jako zdrav\u00e1 populace. Dosud experti na tr\u00e1vic\u00ed trakt p\u0159edpokl\u00e1dali, \u017ee je tato skupina nemoc\u00ed v\u00edce ohro\u017eena <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=43857\" title=\"Lid\u00e9 se st\u0159evn\u00edmi z\u00e1n\u011bty pro\u017e\u00edvaj\u00ed covid-19 a o\u010dkov\u00e1n\u00ed stejn\u011b jako zdrav\u00ed\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":16059,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-43857","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/43857","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=43857"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/43857\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/16059"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=43857"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=43857"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=43857"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}