[Awake prone positioning in covid-19 patients]

Area of Science:

• Critical Care Medicine
• Pulmonology
• Infectious Diseases

Background:

• COVID-19 respiratory failure often necessitates intensive care unit (ICU) admission and invasive mechanical ventilation.
• Awake prone positioning (APP) is a non-invasive technique used globally to improve oxygenation in respiratory distress.

Purpose of the Study:

• To evaluate the efficacy of early awake prone positioning in preventing invasive mechanical ventilation and ICU referral for COVID-19 patients.
• To review existing literature on APP's benefits and drawbacks in COVID-19 respiratory failure.

Main Methods:

• Observation of approximately 30 COVID-19 patients in Suriname undergoing APP.
• Systematic review of existing literature on APP in COVID-19 patients.

Main Results:

• Prospective studies indicate APP can temporarily improve oxygenation but do not demonstrate a reduction in mortality or intubation rates.
• The average symptom duration in reviewed studies was 10-11 days.
• APP in patients with longer symptom duration (beyond 10-11 days) showed no improvement in survival or need for intubation.

Conclusions:

• Awake prone positioning is a simple intervention that may improve oxygenation in COVID-19 patients with respiratory failure.
• Current evidence does not support APP as a method to reduce mortality or the need for invasive mechanical ventilation, especially in patients with prolonged symptoms.
• Prospective studies specifically investigating *early* APP intervention in COVID-19 are lacking.