This multicenter retrospective cohort study was conducted in six hospitals and approved by the Clinical Research Ethics Committee of all centers (31881520.3.1001.5335). Due to the retrospective nature of the study, the need for informed consent was waived. The study included patients under invasive mechanical ventilation with suspected or confirmed SARS-CoV-2 infection, who received prone position sessions for severe COVID-19-ARDS treatment. The inclusion criteria were individuals diagnosed with COVID-19, requiring invasive mechanical ventilation and severe ARDS (PaO2/FiO2 < 150 mmHg). The exclusion criterion was age < 65 years.
Confirmed COVID-19 patients were considered for analysis if they presented a positive real-time reverse transcription-polymerase chain reaction (PCR-RT). Additionally, patients with suspected or negative PCR-RT who presented clinical symptoms of COVID-19, including fever, cough, tiredness, anosmia, ageusia, headache, pain, diarrhea, and/or dyspnea, were also included.
The trained researchers collected data from electronic medical records using standardized forms. All contributors had access to the electronic medical records of their affiliated institutions and were committed to ensuring data protection. Patients were followed up from hospital admission to discharge or death, and the study group did not interfere with medical decisions.
The PaO2/FiO2 ratio was used to assess the oxygenation response. Patients who presented a 20-point improvement in PaO2/FiO2 after the first prone session were considered the responders group. Patients who did not present 20-point of improvement in PaO2/FiO2 after the first prone session were included in the non-responders group. Mortality was defined as deaths that occurred between hospitalization and discharge.
Confirmed COVID-19 patients were considered for analysis if they presented a positive real-time reverse transcription-polymerase chain reaction (PCR-RT). Additionally, patients with suspected or negative PCR-RT who presented clinical symptoms of COVID-19, including fever, cough, tiredness, anosmia, ageusia, headache, pain, diarrhea, and/or dyspnea, were also included.
The trained researchers collected data from electronic medical records using standardized forms. All contributors had access to the electronic medical records of their affiliated institutions and were committed to ensuring data protection. Patients were followed up from hospital admission to discharge or death, and the study group did not interfere with medical decisions.
The PaO2/FiO2 ratio was used to assess the oxygenation response. Patients who presented a 20-point improvement in PaO2/FiO2 after the first prone session were considered the responders group. Patients who did not present 20-point of improvement in PaO2/FiO2 after the first prone session were included in the non-responders group. Mortality was defined as deaths that occurred between hospitalization and discharge.
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