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.
Methods: 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.
Findings: 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.
Interpretation: Significant proportion of patients were noted to have improvement on lateral positioning. In patients unable to…
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