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10.1177/08850666211046532

http://scihub22266oqcxt.onion/10.1177/08850666211046532
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34591701!ä!34591701

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suck abstract from ncbi


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pmid34591701      J+Intensive+Care+Med 2021 ; 36 (11): 1331-1339
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  • Skin Failure Among Critically Ill Patients Afflicted with Coronavirus Disease 2019 (COVID-19) #MMPMID34591701
  • Greenway A; Leahy N; Torrieri L; An A; Fink SA; Witenko C; Shikar M; Winchell RJ; Barie PS; Liu SI
  • J Intensive Care Med 2021[Nov]; 36 (11): 1331-1339 PMID34591701show ga
  • Objective: To characterize skin integrity among coronavirus disease 2019 (COVID-19) patients treated in the intensive care unit (ICU), and identify risk factors for skin failure (SF) in these patients. Design: The characteristic, profound pro-inflammatory, hypercoagulable state of COVID-19 is manifested by the high severity of illness and extensive organ dysfunction observed in these patients. SF in critically ill patients, although described previously, exhibits a uniquely complex pathogenesis in this population. Patients: Retrospective review of all COVID-19 patients (confirmed positive for severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]) admitted to a single surgical ICU for at least 48 hours between March-June 2020. Interventions: Data were extracted from a COVID-19 institutional data repository that harvested data from electronic health records and other clinical data sources. Demographics; coagulation/inflammation biomarkers; number, location, and stage of SF lesions; resource utilization; and outcomes were captured. Measurements and Main Results: 64 patients met inclusion criteria; 51 (80%) developed SF (SF+ ). Forty-three (85%) developed stage 3 or higher SF (chi(2) = 22.66, P < .0001). Thirty-nine of 51 (76%) SF+ patients developed more than one SF lesion (chi(2) = 13.26, P = .0003). SF+ patients manifested a profound pro-inflammatory, hypercoagulable phenotype (lower serum albumin and higher ferritin, interleukin [IL]-6 and D-dimer concentrations [all, P < .001]). Durations of mechanical ventilation, vasopressor therapy, and ICU length of stay were significantly longer (all, P < .05) in the SF + patients. Conclusions: The unique characteristics of COVID-19 dermatopathology and the strong correlation between markers of inflammation and development of SF reflect COVID-19-related organ dysfunction and its deleterious effects on the microcirculation. Considering that skin is invaded directly by SARS-CoV-2 and affected by COVID-19-related immune complex deposition and microthrombosis, SF may reflect disease as opposed to pressure injuries related to processes of care. In the context of COVID-19 critical illness, SF should not be considered a "never event."
  • |*COVID-19[MESH]
  • |*Critical Illness[MESH]
  • |Humans[MESH]
  • |Intensive Care Units[MESH]
  • |Respiration, Artificial[MESH]
  • |Retrospective Studies[MESH]


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