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COMPARISON OF INFLAMMATORY MARKERS AND PRESSURE INJURIES IN INTENSIVE CARE UNIT PATIENTS WITH AND WITHOUT COVID-19 INFECTION

Year 2025, Volume: 29 Issue: 1, 45 - 54, 30.04.2025
https://doi.org/10.62111/ybhd.1619820

Abstract

İntroduction: This study aimed to investigate the relationship between inflammatory markers and pressure injuries in intensive care unit (ICU) patients with and without COVID-19 infection.
Material and Method: Conducted as a retrospective case-control study at a single center. This research took place from April 2020 to February 2021 in a city hospital in Istanbul affiliated with the Turkish Ministry of Health. Following the acquisition of ethical approval, the researchers assessed patients’ ICU records and laboratory findings.
Results: This study found that the mean age of COVID-19 (+) patients was significantly higher compared to COVID-19 (-) patients. In this study, hypertension and diabetes mellitus were the most prevalent comorbidities in both groups. In the current study, the Braden risk scores of COVID-19 (+) patients were found to be lower compared to those of COVID-19 (-) patients. This study found that COVID-19 (+) patients had higher procalcitonin levels, lower lymphocyte and monocyte percentages. COVID-19 (+) patients had a shorter ICU stay compared to COVID-19 (-) patients. The incidence of stage 1 pressure injuries was higher among COVID-19 (+) patients, while stage 3 pressure injuries and suspected tissue damage were more prevalent among COVID-19 (-) patients. Among COVID-19 (+) patients with stage 4 pressure injuries, monocyte levels were lower compared to those with stage 1- 2 injuries.
Conclusion: This study found that COVID-19 (+) patients had higher procalcitonin levels, lower lymphocyte and monocyte percentages, and lower monocyte percentages with increasing pressure injury stages.
Keywords: Pressure injury, COVID-19, infection, Braden risk score, infection parameters

References

  • 1. Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: A study of a family cluster. Lancet. 2020;395:514–23.
  • 2. Çiftci E, Çoksuer F. Novel Coronavirus Infection: COVID-19. FLORA. 2020;25(1):9-18.
  • 3. Chen L, Liu HG, Liu W, et al. Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia. ZhonghuaJie He He Hu XiZaZhi. 2020;43(0): E005.
  • 4. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069.
  • 5. Singh C, Tay J, Shoqirat N. Skin and mucosal damage in patients diagnosed with COVID-19. J Wound Ostomy Continence Nurs. 2020;47(5):435-438.
  • 6. Kurtulus M, Pirim I. COVID-19 and cytokine storm. Forbes J Med. 2020;1(3):55-60
  • 7. Gao YD, Ding M, Dong X, et al. Risk factors for severe and critically ill COVID-19 patients: A review. Allergy. 2021;76(2):428-55.
  • 8. Hahnel E, Lichterfeld A, Blume-Peytavi U, Kottner J. The epidemiology of skin conditions in the aged: A systematic review. J Tissue Viability. 2017;26(1):20-28.
  • 9. Verity R, Okell LC, Dorigatti I, et al. Estimates of the severity of coronavirus disease 2019: A model-based analysis. Lancet Infect Dis. 2020;20(6):669-677.
  • 10. Amini M, Mansouri F, Vafaee K, et al. Factors affecting the incidence and prevalence of pressure ulcers in COVID-19 patients admitted with a Braden scale below 14 in the intensive care unit: Retrospective cohort study. Int Wound J. 2022;19(8):2039–2054.
  • 11. Lovicu E, Faraone A, Fortini A. Admission Braden scale score as an early independent predictor of in-hospital mortality among inpatients with COVID-19: A retrospective cohort study. Worldviews Evid Based Nurs. 2021;18(5):247-253.
  • 12. Boyko TV, Longaker MT, Yang GP. Review of the current management of pressure ulcers. Adv Wound Care. 2018;7(2):57–67.
  • 13. Labeau SO, Afonso E, Benbenishty J, et al. Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: The DecubICUs study. Intensive Care Med. 2021;47(2):160–169.
  • 14. Guerin C. Prone positioning acute respiratory distress syndrome patients. Ann Transl Med. 2017;5(14):289.
  • 15. Munshi L, Del Sorbo L, Adhikari NK, et al. Prone position for acute respiratory distress syndrome. A systematic review and meta-analysis. Ann Am Thorac Soc. 2017;14(4):280-288.
  • 16. Pressure Injury Prevention Points. The National Pressure Injury Advisory Panel (NPIAP), 2016. https://npiap.com/. Erişim Tarihi: 10.06.2024.
  • 17. Sardo PMG, Guedes JAD, Alvarelhao JJM, Machado PAP, Pinheiro Melo EMO. Pressure ulcer incidence and Braden subscales: Retrospective cohort analysis in general wards of a Portuguese hospital. J Tissue Viability. 2018;27(2):95-100.
  • 18. Şen P, Demirdal T. Factors Associated with intensive care unit admission and mortality in COVID-19 infection during May-August 2020 period. Klimik Journal. 2022;35(2):68-73.
  • 19. Ayoglu H. Intensive care approach in COVID-19 patients. Turk J Diab Obes. 2020;2:183-193.
  • 20. Gocmen Baykara Z, Eyuboglu G. Nursing care in the Covid 19 pandemic. Gazi Journal of Health Sciences. 2020;9-17.
  • 21. Tharakan S, NomotoK, Miyashita S, Ishikawa K. Body temperature correlates with mortality in COVID-19 patients. Crit Care. 2020;24(1):298.
  • 22. Gefen A, Ousey K. COVID-19, fever and dressings used for pressure ulcer prevention: Monthly update. J Wound Care. 2020;29(8):430-431.
  • 23. Gokturk O, Gokturk K, Cil E. The role of biomarkers in determining prognosis in clinical monitoring of Covid-19. J Med Clin. 2024;7(3):89-95.
  • 24. Keskin A. Prognostic value of laboratory parameters in patients with SARS-COV-2 infection. Eurasian J Bio Chem Sci. 2022;5(2):100-104.
  • 25. Unver-Ulusoy T, Demirkose M, Can Bilek H. Diagnostic utility and prognostic value of basic laboratory parametersin COVID-19. Klimik Journal. 2021;34(3):174-81.
  • 26. Ozmen Suner K, Kocayigit H, Demir G, Tomak Y, Yaylacı S, Erdem AF. The Relationship between hemoglobin levels and intensive care mortality in COVID-19 patients. J Contemp Med. 2022;12(5):660-664.
  • 27. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;58(7):1131-1134.
  • 28. Tan L, Wang Q, Zhang D, et al. Lymphopenia predicts disease severity of COVID-19: A descriptive and predictive study. Signal Transduct Target Ther. 2020;5(1):33.
  • 29. Qin S, Jiang Y, Wei X, et al. Dynamic changes in monocytes subsets in COVID-19 patients. Hum Immunol. 2021;82(3):170-176.

Comparison Of Inflammatory Markers and Pressure Ulcer In Intensive Care Unit Patients With and Without Covid-19 Infection

Year 2025, Volume: 29 Issue: 1, 45 - 54, 30.04.2025
https://doi.org/10.62111/ybhd.1619820

Abstract

aim: This study aimed to investigate the relationship between inflammatory markers and pressure injuries in intensive care unit (ICU) patients with and without COVID-19 infection.
Material and Method: Conducted as a retrospective case-control study at a single center. This research took place from April 2020 to February 2021 in a city hospital in Istanbul affiliated with the Turkish Ministry of Health. Following the acquisition of ethical approval, the researchers assessed patients’ ICU records and laboratory findings.
Results: This study found that the mean age of COVID-19 (+) patients was significantly higher compared to COVID-19 (-) patients. In this study, hypertension and diabetes mellitus were the most prevalent comorbidities in both groups. In the current study, the Braden risk scores of COVID-19 (+) patients were found to be lower compared to those of COVID-19 (-) patients. This study found that COVID-19 (+) patients had higher procalcitonin levels, lower lymphocyte and monocyte percentages. COVID-19 (+) patients had a shorter ICU stay compared to COVID-19 (-) patients. The incidence of stage 1 pressure injuries was higher among COVID-19 (+) patients, while stage 3 pressure injuries and suspected tissue damage were more prevalent among COVID-19 (-) patients. Among COVID-19 (+) patients with stage 4 pressure injuries, monocyte levels were lower compared to those with stage 1- 2 injuries.
Conclusion: This study found that COVID-19 (+) patients had higher procalcitonin levels, lower lymphocyte and monocyte percentages, and lower monocyte percentages with increasing pressure injury stages.

References

  • 1. Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: A study of a family cluster. Lancet. 2020;395:514–23.
  • 2. Çiftci E, Çoksuer F. Novel Coronavirus Infection: COVID-19. FLORA. 2020;25(1):9-18.
  • 3. Chen L, Liu HG, Liu W, et al. Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia. ZhonghuaJie He He Hu XiZaZhi. 2020;43(0): E005.
  • 4. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069.
  • 5. Singh C, Tay J, Shoqirat N. Skin and mucosal damage in patients diagnosed with COVID-19. J Wound Ostomy Continence Nurs. 2020;47(5):435-438.
  • 6. Kurtulus M, Pirim I. COVID-19 and cytokine storm. Forbes J Med. 2020;1(3):55-60
  • 7. Gao YD, Ding M, Dong X, et al. Risk factors for severe and critically ill COVID-19 patients: A review. Allergy. 2021;76(2):428-55.
  • 8. Hahnel E, Lichterfeld A, Blume-Peytavi U, Kottner J. The epidemiology of skin conditions in the aged: A systematic review. J Tissue Viability. 2017;26(1):20-28.
  • 9. Verity R, Okell LC, Dorigatti I, et al. Estimates of the severity of coronavirus disease 2019: A model-based analysis. Lancet Infect Dis. 2020;20(6):669-677.
  • 10. Amini M, Mansouri F, Vafaee K, et al. Factors affecting the incidence and prevalence of pressure ulcers in COVID-19 patients admitted with a Braden scale below 14 in the intensive care unit: Retrospective cohort study. Int Wound J. 2022;19(8):2039–2054.
  • 11. Lovicu E, Faraone A, Fortini A. Admission Braden scale score as an early independent predictor of in-hospital mortality among inpatients with COVID-19: A retrospective cohort study. Worldviews Evid Based Nurs. 2021;18(5):247-253.
  • 12. Boyko TV, Longaker MT, Yang GP. Review of the current management of pressure ulcers. Adv Wound Care. 2018;7(2):57–67.
  • 13. Labeau SO, Afonso E, Benbenishty J, et al. Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: The DecubICUs study. Intensive Care Med. 2021;47(2):160–169.
  • 14. Guerin C. Prone positioning acute respiratory distress syndrome patients. Ann Transl Med. 2017;5(14):289.
  • 15. Munshi L, Del Sorbo L, Adhikari NK, et al. Prone position for acute respiratory distress syndrome. A systematic review and meta-analysis. Ann Am Thorac Soc. 2017;14(4):280-288.
  • 16. Pressure Injury Prevention Points. The National Pressure Injury Advisory Panel (NPIAP), 2016. https://npiap.com/. Erişim Tarihi: 10.06.2024.
  • 17. Sardo PMG, Guedes JAD, Alvarelhao JJM, Machado PAP, Pinheiro Melo EMO. Pressure ulcer incidence and Braden subscales: Retrospective cohort analysis in general wards of a Portuguese hospital. J Tissue Viability. 2018;27(2):95-100.
  • 18. Şen P, Demirdal T. Factors Associated with intensive care unit admission and mortality in COVID-19 infection during May-August 2020 period. Klimik Journal. 2022;35(2):68-73.
  • 19. Ayoglu H. Intensive care approach in COVID-19 patients. Turk J Diab Obes. 2020;2:183-193.
  • 20. Gocmen Baykara Z, Eyuboglu G. Nursing care in the Covid 19 pandemic. Gazi Journal of Health Sciences. 2020;9-17.
  • 21. Tharakan S, NomotoK, Miyashita S, Ishikawa K. Body temperature correlates with mortality in COVID-19 patients. Crit Care. 2020;24(1):298.
  • 22. Gefen A, Ousey K. COVID-19, fever and dressings used for pressure ulcer prevention: Monthly update. J Wound Care. 2020;29(8):430-431.
  • 23. Gokturk O, Gokturk K, Cil E. The role of biomarkers in determining prognosis in clinical monitoring of Covid-19. J Med Clin. 2024;7(3):89-95.
  • 24. Keskin A. Prognostic value of laboratory parameters in patients with SARS-COV-2 infection. Eurasian J Bio Chem Sci. 2022;5(2):100-104.
  • 25. Unver-Ulusoy T, Demirkose M, Can Bilek H. Diagnostic utility and prognostic value of basic laboratory parametersin COVID-19. Klimik Journal. 2021;34(3):174-81.
  • 26. Ozmen Suner K, Kocayigit H, Demir G, Tomak Y, Yaylacı S, Erdem AF. The Relationship between hemoglobin levels and intensive care mortality in COVID-19 patients. J Contemp Med. 2022;12(5):660-664.
  • 27. Lippi G, Plebani M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med. 2020;58(7):1131-1134.
  • 28. Tan L, Wang Q, Zhang D, et al. Lymphopenia predicts disease severity of COVID-19: A descriptive and predictive study. Signal Transduct Target Ther. 2020;5(1):33.
  • 29. Qin S, Jiang Y, Wei X, et al. Dynamic changes in monocytes subsets in COVID-19 patients. Hum Immunol. 2021;82(3):170-176.
There are 29 citations in total.

Details

Primary Language English
Subjects Surgical Diseases Nursing​​, ICU Nursing
Journal Section Research
Authors

Aysenur Ata 0000-0002-4670-9731

Rabia Koca 0000-0001-5681-9240

Kemal Tolga Saraçoğlu 0000-0002-6320-1403

Publication Date April 30, 2025
Submission Date January 14, 2025
Acceptance Date April 15, 2025
Published in Issue Year 2025 Volume: 29 Issue: 1

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Content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

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