Pressure lesions: incidence in critical patient with pneumonia due to SARS-CoV-2 in response to decubitus prone position during COVID-19 pandemic

Abstract

Introduction: Pressure injuries (PPL) are one of the main problems in the health network; with prolonged hospital stays and increasing complications in health status. SARS-CoV-2 carried the patient in prone position (PD) for prolonged times, generating PPL in unexperienced anatomical regions compared to PPL in patients in the supine position, however PD proved to be the first line to solve the lack of mechanical ventilation equipment, significantly increasing the oxygenation index, better known as PaFi (PaO2/FiO2).

Objective: To calculate the incidence of PPL in the critical COVID patient taken to the PD, to describe the type of patients and the lesions identified.

Methodology: Cross-sectional descriptive observational study with a retrospective approach, data collection was performed in a tertiary hospital in Mexico City; included 250 patients who were admitted to COVID critical areas during the 2020 period, only post-admission LPP was considered, the electronic record and wound clinic records were analyzed, applying percentages, frequencies and Pearson correlation, data collection was generated in Excel and statistical analysis SPSS.

Results: The incidence of PPL is 18.05% similar to international studies, PPL with slough correspond to 33.9% and necrosis to 40% occupying the higher incidence, the anatomical location in the pinna, cheekbones, thorax is 36.1% and 46.5% were category III lesions with involvement of the muscle structures. The relationship between BMI and PPL showed that overweight patients BMI 25-29.9 had a higher incidence of PPL with fibrin and slough by 60.3%; In relation to BMI and anatomical location, patients with obesity or a BMI of 30.0-39.9 were the patients who presented the highest increased number of injuries.

Study limitation: variables such as nursing workload were not considered.

Originality: this research has not been previously postulated in any editorial body.

Conclusions: The incidence coincides with studies in other countries, it is necessary to standardize actions aimed at the prevention of LPP, in order to reduce its incidence in the patient with PD.