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

Adv Skin Wound Care. 2023 Aug 1;36(8):421-434. doi: 10.1097/ASW.0000000000000005.

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.

Publication types

  • Systematic Review

MeSH terms

  • COVID-19* / epidemiology
  • Hospitalization
  • Hospitals
  • Humans
  • Length of Stay
  • Male
  • Pressure Ulcer* / epidemiology
  • Pressure Ulcer* / prevention & control