COVID-19 and Hospital-Acquired Pressure Injuries: A Systematic Review

Abstract

OBJECTIVE To investigate the relationship between COVID-19-related variables and hospital-acquired pressure injury (HAPI) incidence. DATA SOURCES The authors searched four databases: Cochrane, MEDLINE, EMBASE, and CINAHL. The literature search contained key terms such as “COVID-19,” “hospital-acquired pressure injuries,” “pressure ulcer,” “pressure injury,” “decubitus ulcer,” and “hospitalization.” STUDY SELECTION The systematic search of the literature identified 489 publications that matched the inclusion criteria. Articles were included in the review if they were peer-reviewed publications that reported HAPI incidence for patients who were hospitalized and COVID-19 positive. Two reviewers performed the screen simultaneously, and 19 publications were included. DATA EXTRACTION Two reviewers followed a standardized extraction form that included study and patient characteristics, COVID-19 status, HAPI characteristics, prone positioning, length of hospitalization, and HAPI prevention and treatment strategies. DATA SYNTHESIS The authors carried out a narrative synthesis of the extracted data because the data obtained were too heterogeneous for meta-analysis. The primary outcome was HAPI incidence. CONCLUSIONS This review identified that HAPI incidence was high among men who were COVID-19 positive, had longer hospital stays, experienced prone positioning, and had care teams without a skin and wound care expert. Future research should use more robust methodology and focus on quantitative modeling to iteratively improve inpatient HAPI guidelines.

Association between hypertension and pressure ulcer: A systematic review and meta‐analysis

“…In a recent retrospective cohort study in Iran, Alamdari 33 found that PU were observed significantly more in metabolic syndrome group (including hypertension) compared with non‐metabolic syndrome group among COVID‐19 patients. Additionally, in a recent meta‐analysis about COVID‐19 and PU, Adrienn 34 suggested that both intrinsic factors (e.g, comorbidities, including hypertension) and extrinsic factors can further increase the risk of Hospital‐Acquired Pressure Injuries for patients with COVID‐19. Due to the uneven approach to testing, the reviews do not give qualitative conclusions; however, the results indirectly support our findings.…”