Incidence and Risk Factors for Hospital-Acquired Pressure Ulcers in Patients With COVID-19

Hospital-acquired pressure ulcers (HAPU) are a major challenge in healthcare settings, especially in vulnerable populations such as patients with COVID-19. The aim of this study is to examine the association of COVID-19 infection with occurrence of HAPU, with the goal of enhancing care protocols and reducing HAPU incidence in at-risk populations.

A retrospective analysis was conducted for 8,158 hospitalized patients aged 20 years and older who were treated from April 2022 to March 2023. The study included COVID-19-positive patients and non-COVID-19 patients. Data were collected for age, sex, body mass index, total protein, albumin (ALB), hemoglobin, COVID-19 infection, and independence in activities of daily living (ADL). For patients with COVID-19, surgical history, intensive care unit admission, physical restraints, mechanical ventilation, and prone positioning therapy were also examined. Risk factors for HAPU were evaluated based on these variables.

In all 8,158 patients, low ALB and COVID-19 infection were independent risk factors for HAPU. In the COVID-19 cohort (n=412), low independence in ADL was also an independent risk factor. These findings underscore the importance of targeted interventions to mitigate the occurrence of HAPU, particularly for high-risk COVID-19 patients.

This study showed that advanced age, low ALB, and COVID-19 infection are significant independent risk factors for HAPU. For COVID-19 patients, isolation policies may have reduced caregiver-patient interactions and hindered the delivery of frequent care, thereby increasing the risk of HAPU, particularly in patients with low ADL independence. For high-risk patients, a multidisciplinary approach is essential, with tailored PU prevention strategies implemented early to address individual needs and reduce the risk of HAPU.