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Prone Position in Management of COVID-19 Patients; a Commentary

Parisa Ghelichkhani, Maryam Esmaeili



SARS-CoV-2 virus causes a pneumonia that was identified through fever, dyspnea, and acute respiratory symptoms and named COVID-19. This disease exacerbates in a number of patients and causes pulmonary edema, multi-organ failure, and acute respiratory distress syndrome (ARDS). Prevalence of ARDS among COVID-19 patients has been reported to be up to 17%. Among the introduced treatment methods for management of ARDS patients, prone position can be used as an adjuvant therapy for improving ventilation in these patients. Here we reviewed the literature regarding the role of prone position in management of COVID-19 patients.


COVID-19; severe acute respiratory syndrome coronavirus 2; sars-cov-2; prone position; respiratory distress syndrome, adult; pandemics


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Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395(10223):507-13.

Matthay MA, Zemans RL, Zimmerman GA, Arabi YM, Beitler JR, Mercat A, et al. Acute respiratory distress syndrome. Nature Reviews Disease Primers. 2019;5(1):1-22.

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Guérin C, Reignier J, Richard J-C, Beuret P, Gacouin A, Boulain T, et al. Prone Positioning in Severe Acute Respiratory Distress Syndrome. New England Journal of Medicine. 2013;368(23):2159-68.

Munshi L, Del Sorbo L, Adhikari NKJ, Hodgson CL, Wunsch H, Meade MO, et al. Prone Position for Acute Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis. Annals of the American Thoracic Society. 2017;14(Supplement_4):S280-s8.

Mora-Arteaga J, Bernal-Ramírez O, Rodríguez S. The effects of prone position ventilation in patients with acute respiratory distress syndrome. A systematic review and metaanalysis. Medicina Intensiva (English Edition). 2015;39(6):359-72.

Guerin C, Beuret P, Constantin JM, Bellani G, Garcia-Olivares P, Roca O, et al. A prospective international observational prevalence study on prone positioning of ARDS patients: the APRONET (ARDS Prone Position Network) study. Intensive care medicine. 2018;44(1):22-37.

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DOI: https://doi.org/10.22037/aaem.v8i1.674

DOI (PDF): https://doi.org/10.22037/aaem.v8i1.674.g772

DOI (HTML): https://doi.org/10.22037/aaem.v8i1.674.g800