Awake Prone Positioning in COVID-19 Patients

Area of Science:

• Critical Care Medicine
• Pulmonology
• Infectious Diseases

Background:

• COVID-19, caused by SARS-CoV-2, presents with significant respiratory symptoms.
• Prone positioning is a known therapy for Acute Respiratory Distress Syndrome (ARDS) to enhance oxygenation.
• Awake proning is an emerging strategy to avoid invasive ventilation in COVID-19 patients.

Purpose of the Study:

• To evaluate the benefits of awake prone positioning combined with oxygen therapy.
• To assess the impact on oxygenation and the need for invasive ventilation in non-intubated COVID-19 patients.

Main Methods:

• A retrospective case study of 15 COVID-19 patients in HDU.
• Inclusion criteria: hemodynamically stable, SpO2 < 90%.
• Patients received oxygen therapy and were encouraged to prone for 10-12 hours daily, monitoring SpO2 and P/f ratio.

Main Results:

• Mean SpO2 on room air admission was 80%.
• Prone positioning improved mean P/f ratio from 98.8 ± 29.7 mm Hg to 136.6 ± 38.8 mm Hg (p=0.005).
• Only two patients required intubation; mean hospital stay was 11 days.

Conclusions:

• Awake prone positioning markedly improves P/f ratio and SpO2 in COVID-19 patients.
• This intervention leads to better clinical symptoms and a reduced intubation rate.
• Awake proning with oxygen therapy is effective for mild to moderate COVID-19 cases.