ABSTRACT
Background: Awake prone positioning (APP) under CARP protocol is widely used in the management of patients with coronavirus disease (COVID-19) in recent years. The primary objective of this study was to compare the outcome. Aim: Compare the outcome of COVID-19 patients who received early versus late awake prone position in terms of oxygenation, patient comfort, increased nonventilatory days, and final outcome. Settings and design: Single centre, retrospective and observational study. Materials and methods: Analysis of data collected for a randomized controlled trial in adult patients with acute hypoxemic respiratory failure secondary to COVID-19, who received awake prone positioning under CAPR protocol for minimal one hour were included. Early prone positioning was defined as APP initiated within 24 h of high-flow nasal cannula (HFNC) start. 50 patients were included in the study. Primary outcomes were patient comfort, hospital stay, complications during ICU stay, 28-day mortality, and intubation rate. Statistical analysis: Data analysis was done using SPSS software. P value < 0.05 was considered statistically significant. Results: We included 50 patients between the ages of 18 and 60 years. The early APP group had lower mortality compared to the late APP group but no difference was found in intubation rate. Advanced age, intubation, longer time to initiate APP were associated with increased mortality. Conclusion: Early initiation (< 24 h of HFNC use) of APP in acute hypoxemic respiratory failure secondary to COVID-19 improves 28-day survival.