How the COVID-19 pandemic influences the prevalence of pressure injuries in the Czech Republic: A nationwide analysis of a health registry in 2020

BACKGROUND

COVID-19 significantly influences the overall patient status and, in severe symptomatology, the ability to move and the low oxygenation of the tissue for the ventilated patient in Intensive Care Units (ICU). There is a higher risk for Pressure injuries (PIs) development.

OBJECTIVES

The nationwide analyses of the National health register aimed to compare the prevalence of PIs reported before the pandemic COVID-19 started and during the pandemic in 2020.

METHOD

A retrospective, nationwide cross-sectional analysis of data regarding the STROBE checklist collected by the National Health Information System (NHIS), focusing on the PIs reporting based on the International Classification of Diseases (ICD-10) diagnoses L89.0-L89.9 for PIs in 2020. The data from the pandemic period of COVID-19 in 2020 were compared to the prevalence of PI cases in the period 2010-2019 in the Czech Republic in all hospitalized patients.

RESULTS

The total number of admissions for L89 in 2020 was 14,441, of which 1509 (10.4%) also had COVID-19. In the ICU were 4386 admissions, 12.1% of which also had COVID-19. A higher proportion of PIs is observed in patients hospitalized with COVID-19 than in patients without COVID-19 (2.62% vs 0.81%, respectively 1.05% vs 0.46% when standardized to the 2013 ESP = European Standard Population). In patients hospitalized in ICU, 3.68% with COVID-19 had PIs vs 1.42% without COVID-19 had PIs (1.97% vs 0.81% using the 2013 ESP).

CONCLUSION

The national health registers analyses have proven that the prevalence of PIs was higher among patients hospitalized with the SARS-CoV-2 infection.

[The importance of evaluating the effectiveness of the ventilation VE/VCO2 slope in patients with heart failure]

Chronic Heart Failure (CHF) is accompanied by a whole range of symptoms, which significantly decrease the quality of life; these typically concern dyspnoea, fatigue and exercise intolerance. The objectification of the patients condition but must have an effective means of evaluation. One such resource is cardiopolmonary exercise (CPX) testing with it is functional parameters. CPX test with its functional parameters is one of such means. VO2peak is undoubtebly the parameter, which was used the most often in the past 25 years, however, it has many limitations. It is reason, why the evaluation of ventilation effectiveness using the VE/VCO2 slope is becoming more and more the centre of Czech and foreign interest of cardiologists abroad. Foreign studies have unambiguously proven that because of the absence of the fundamental limitations, such as in case of VO2peak, the VE/VCO2 slope is a stronger predictor of the amount of hospitalizations and of mortality in the population of patients suffering from CHF. This short overview intends to inform of the significant merit of this parameter. That is the reason why the VE/VCO2 should be classified as a standard criterion in indication of heart transplantations, but also in evaluation of seriousness and prognosis in population of patient suffering from HF.Key words: heart failure - mortality - prognosis - ventilation efficiency - VE/VCO2 slope.