The Effect of Prone Position on Clinical Outcomes of Non-Intubated Patients with Covid-۱۹: A Randomized Controlled Clinical Trial

Background and Objective: Prone positioning (PP) is a well-known respiratory support strategy. Limited data are available for the use of PP in non-intubated patients with COVID-۱۹. This study aims to investigate the effect of PP on the clinical outcomes of patients with COVID-۱۹ pneumonia.Material and Methods: This clinical trial selected its patients by permuted block randomization and assigned the samples to the PP (n=۴۱) and control (n=۴۱) groups. In the first phase, the participants in the PP group were asked to lie comfortably in a prone positioning for ۹۰ min. In the control group, the participants were asked to lie comfortably in a supine position for ۹۰ min. Clinical data like oxygen saturation, respiratory rate, the severity of dyspnea, mean arterial pressure, and pulse rate were assessed at ۰, ۳۰, ۶۰, ۹۰, and ۱۲۰ min the intervention. In the second phase, the participants in the PP group were asked to intermittently stay in a prone position for eight h during the ۲۴ h of hospitalization. The participants in the control group were asked to remain in their usual positions during the hospital stay. In this phase, the length of hospital stay, intubation rate, and survival save were assessed. The data were analyzed with SPSS, version ۲۲, using the Chi-Square, Mann-Whitney, repeated measures ANOVA and Fishers exact tests. The trial was registered at the Iranian Registry of Clinical Trials (IRCT۲۰۱۶۰۱۲۶۰۲۶۲۱۷N۴).Findings: Prone positioning was associated with significant improvement in SPO۲ (P = ۰.۰۰۱), RR (P=۰.۰۰۴), the severity of dyspnea (P=۰.۰۱۴), and MAP (P=۰.۰۲۷). There was no significant difference between the two groups in terms of hospital stay (P=۰.۹۹۴), the intubation rate (P=۰.۳۲۴), and survival (P=۰.۰۹۱).Conclusions: Prone positioning can be considered an inexpensive, accessible, and simple measure in awake non-intubated patients with COVID-۱۹ to improve some short-term clinical outcomes.

کلیدواژه ها:

Acute respiratory distress syndrome ، Coronavirus ، Covid-۱۹ ، Prone Position