Effect of Prone Positioning in Patients with Moderate COVID-19 Pneumonia Admitted to Ward at a Tertiary Care Hospita

Abstract

COVID -19 pneumonia can progress to severe disease in 5% of patients requiring intensive care management, which can put an excessive burden on health care systems. Prone positioning has been shown to improve oxygenation and decrease lung injury in patients with COVID-19 pneumonia and can be used as an adjunctive treatment to delay intubation. The objective of this study is to assess the effect of prone positioning in patients admitted to the COVID ward, with Moderate COVID-19 Pneumonia. This experimental study was conducted at Liaquat National Hospital. A quasi-experimental study design was applied. Patients with hypoxemia SpO2 < 94% were assisted to prone and semi-prone for up to 2 hours at a time for multiple sessions. Parameters like SaO2 , PaO2 /FiO2 , hours of proning and changes and X-rays were recorded daily and pre and post-intervention values were compared. Paired t-test and Wilcoxon sign test were used to compare continuous parameters. A two-tailed p-value less than 5% of the level of significance was defined as statistically significant. 20 patients fulfilling the inclusion criteria were enrolled. Median hours of prone positioning were 48.5. The median hospital stay was 7.5 days. At baseline, mean PaO2 /FiO2 ratio was 342±91.87 and at the time of discharge, it was 412.30±105.97 which is a statistically significant improvement from baseline (p=0.040). 50% of patients showed improvement in X-rays. One patient was intubated and all the patients were discharged. The sample collected in the current showed that prone positioning is a safe and feasible approach to improve oxygenation in moderate-severe COVID-19 pneumonias. However, studies with a larger sample size are recommended to further verify the findings of this study

Keywords

• awake proning
• hypoxia
• moderate covid-19 pneumonia
• prone position