Effect of prone position on clinical outcomes of nonintubated patients with COVID-19: A randomised clinical trial.

ABSTRACT

Background: Prone positioning (PP) is a well-known respiratory support approach. Limited data are available for the use of PP in nonintubated patients with COVID-19. Aim: This study aims to investigate the effect of PP on the clinical outcomes of patients with COVID-19 pneumonia. Methods: In this clinical trial, the participants in the PP group (n = 41) were asked to lie comfortably in a PP for 90 min. In the supine position (SP) group (n = 41), the participants were asked to lie comfortably in a SP for 90 min. Clinical data such as oxygen saturation, respiratory rate (RR), the severity of dyspnoea, mean arterial pressure (MAP), and pulse rate were assessed at 0 (immediately before), 30, 60, and 90 min after the start of the intervention, and 30 min after resuming the SP. The participants in the PP group were then asked to intermittently stay in a PP for a total of 8 h per 24 h of hospitalisation. The participants in the control group were asked to remain in their usual positions during the hospital stay. Finally, the length of hospital stay, intubation rate, and survival were assessed. Findings: PP was associated with significant improvement in oxygen saturation (P = 0.001), RR (P = 0.004), the severity of dyspnoea (P = 0.014), and MAP (P = 0.027). There was no significant difference between the two groups in terms of pulse rate (P = 0.890), hospital stay (P = 0.994), intubation rate (P = 0.324), and survival (P = 0.091). Discussion: Our results demonstrated that PP showed marked improvement in some short-term clinical outcomes in nonintubated patients with COVID-19. Conclusion: PP can be considered an inexpensive, accessible, and simple measure in awake nonintubated patients with COVID-19.