Lateral Positioning in COVID-19 Pneumonia, A Cross Sectional Study Among 300 Patients

Abstract

Background: The efficacy of lateral positioning in lung pathologies have been evaluated in few studies, though none give a definitive conclusion. We have performed this study on 300 COVID-19 infected patients to determine the improvement in oxygen levels on lateral decubitus in comparison to semi-recumbent position, to correlate with lung imaging findings, and also to assess these correlations within various severities of illness. \n \nMethods: In this cross sectional study we recorded spO2 of 300 spontaneously breathing, non intubated hemodynamically stable adult COVID-19 RTPCR positive patients on semi-recumbent, left decubitus and right decubitus positions. They were segregated into three severity groups, based on clinical signs, semi-recumbent oxygen levels, respiratory rate and lung findings, and data analysed separately in each group.\xa0 \n \nFindings: 194 (64%) out of all 300 participants had improved oxygenation on lateral decubitus. The changes ranged from 2% drop to 5% gain in spO2 levels, while on right decubitus it varied from a 3% drop to 7% gain. 92.3% of patients who improved on left lateral positioning had infiltrates predominantly in right lung, and 69.1% patients with improvement on right lateral had left lung involved. Similar observations were made in all three severity groups and all correlations were statistically significant with p<0.001.\xa0 \n \nInterpretation: Significant proportion of patients were noted to have improvement on lateral positioning. In patients unable to lie prone, caregivers may be educated to make patients preferentially lie on their sides with lesser lung involvement for better improvement in oxygen levels and a faster recovery. \n \nFunding: No funds used for this study. \n \nDeclaration of Interests: None. \n \nEthics Approval Statement: This is an observational cross sectional study conducted on 300 hemodynamically stable, spontaneously breathing, non-intubated adult patients with COVID-19 pneumonia in COVID ward of Govt Kilpauk hospital. This study took place for six months after Ethical committee approval.