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

Abstract

ABSTRACTOBJECTIVETo investigate the relationship between COVID-19-related variables and hospital-acquired pressure injury (HAPI) incidence.DATA SOURCESThe 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 SELECTIONThe 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 EXTRACTIONTwo 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 SYNTHESISThe 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.CONCLUSIONSThis 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.