Abstract
Pressure Injuries (PIs) are major worldwide public health threats within the different health-care settings. To describe and compare epidemiological and clinical features of PIs in COVID-19 patients and patients admitted for other causes in Internal Medicine Units during the first wave of COVID-19 pandemic. A descriptive longitudinal retrospective study. This study was conducted in Internal Medicine Units in Salamanca University Hospital Complex, a tertiary hospital in the Salamanca province, Spain. All inpatients ≥18-year-old admitted from March 1, 2020 to June 1, 2020 for more than 24 hours in the Internal Medicine Units with one or more episodes of PIs. A total of 101 inpatients and 171 episodes were studied. The prevalence of PI episodes was 6% and the cumulative incidence was 2.9% during the first-wave of COVID-19. Risk of acute wounds was four times higher in the COVID-19 patient group (p<0.001). Most common locations were sacrum and heels. Among hospital acquired pressure injuries a significant association was observed between arterial hypertension and diabetes mellitus in patients with COVID-19 diagnosis. During the first wave of COVID-19, COVID-19 patients tend to present a higher number of acute wounds, mainly of hospital origin, compared to the profile of the non-COVID group. Diabetes mellitus and arterial hypertension were identified as main associated comorbidities in patients with COVID-19 diagnosis.
Highlights
Since the outbreak of the novel coronavirus (2019-nCoV) in December 2019 in Wuhan, China, confirmed cases have appeared in countries around the world with a serious impact in Spain, where the situational reports of World Health Organization (WHO) revealed 239 801 confirmed cases of COVID and 29 045 deaths as of June 2020 [1], period considered to be the first wave in this country.National Pressure Injury Advisory Panel (NPIAP) points out that COVID-19 crisis has brought significant changes in the implementation of preventive measures of pressure injuries (PI) [2], especially in the middle of the pandemic, since some patients spend prolonged stays in Intensive Care Unit (ICU) or other medical services
Among hospital acquired pressure injuries a significant association was observed between arterial hypertension and diabetes mellitus in patients with COVID-19 diagnosis
The last European Pressure Ulcer Advisory Panel (EPUAP) Virtual Meeting in September 2020 [3] highlighted etiology factors linked to development of PIs such as COVID-19 virus pathophysiology [4–7], the role of inflammation, limited reposition caused by hemodynamic instability or profound hypoxia, use of prone position as adjuvant therapy and the increase in the use of medical device-related PIs
Summary
National Pressure Injury Advisory Panel (NPIAP) points out that COVID-19 crisis has brought significant changes in the implementation of preventive measures of pressure injuries (PI) [2], especially in the middle of the pandemic, since some patients spend prolonged stays in Intensive Care Unit (ICU) or other medical services. The last European Pressure Ulcer Advisory Panel (EPUAP) Virtual Meeting in September 2020 [3] highlighted etiology factors linked to development of PIs such as COVID-19 virus pathophysiology (systemic coagulopathy, hypercoagulation, microvascular occlusion) [4–7], the role of inflammation, limited reposition caused by hemodynamic instability or profound hypoxia, use of prone position as adjuvant therapy and the increase in the use of medical device-related PIs (tracheostomy tubes, feeding tubes and oxygen delivery devices). Pressure Injuries (PIs) are major worldwide public health threats within the different healthcare settings
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