6/28/23, 12:18 AM COVI-PRONE Pathway Feedback Search Clinical Topics Home Studies COVI PRONE COVI PRONE Disease COVID 19 infection Trial question What is the role of awake prone positioning in patients with COVID-19 and acute respiratory failure? Study design Multi-center Open label RCT Population Characteristics of study participants 29.0% female N = 400 71.0% male 400 patients (117 female, 283 male) Inclusion criteria: nonintubated adult patients with acute hypoxemia and COVID-19 Key exclusion criteria: receipt of invasive mechanical ventilation; contraindications to prone positioning; at risk of complications from prone positioning; prior self-prone positioning Interventions N=205 prone positioning (awake prone positioning sessions for 8-10 hours/day with usual care) N=195 usual care (usual care alone) Primary outcome Rate of endotracheal intubation within 30 days 40.5 40.5 % 34.1 https://web.pathway.md/studies/rec4P3tV18UpSuhCN 1/2 6/28/23, 12:18 AM COVI-PRONE Pathway 30.4 % 20.3 % 10.1 % No significant difference 0.0 % Prone positioning Usual care No significant difference in the rate of endotracheal intubation within 30 days (34.1% vs. 40.5%; HR 0.81, 95% CI 0.59 to 1.12) Secondary outcomes No significant difference in death at day 60 (22% vs. 24%; HR 0.93, 95% CI 0.62 to 1.4) No significant difference in days free from invasive mechanical ventilation or noninvasive ventilation at day 30 (21.4% vs. 19.4%; MD 2.04, 95% CI -0.5 to 4.59) No significant difference in hospital free days at day 60 (34.4% vs. 30.8%; MD 3.52, 95% CI -1.05 to 8.08) Safety outcomes Significant difference in adverse events including musculoskeletal pain or discomfort from prone positioning (10% vs. 0%). Conclusion In nonintubated adult patients with acute hypoxemia and COVID-19, prone positioning was not superior to usual care with respect to the rate of endotracheal intubation within 30 days. Reference Waleed Alhazzani, Ken Kuljit S Parhar, Jason Weatherald et al. Effect of Awake Prone Positioning on Endotracheal Intubation in Patients With COVID-19 and Acute Respiratory Failure: A Randomized Clinical Trial. JAMA. 2022 Jun 7;327(21):2104-2113. Open reference URL https://web.pathway.md/studies/rec4P3tV18UpSuhCN 2/2