The SARS-CoV-2 can lead to severe illness with COVID-19.Outcomes of patients requiring mechanical ventilation are poor.Awake proning in COVID-19 improves oxygenation, but on data clinical outcomes is limited.This single-centre retrospective study aimed to assess CREAMY CLAY whether successful awake proning of patients with COVID-19, requiring respiratory support (continuous positive airways pressure (CPAP) or high-flow nasal oxygen (HFNO)) on a respiratory high-dependency unit (HDU), is associated with improved outcomes.
HDU care included awake proning by respiratory physiotherapists.Of 565 patients admitted with COVID-19, 71 (12.6%) were managed on the respiratory HDU, with 48 of these (67.6%) requiring respiratory support.
Patients managed with CPAP alone 22/48 (45.8%) were significantly less likely to die than patients who required transfer onto HFNO 26/48 (54.2%): CPAP mortality 36.4%; HFNO mortality 69.
2%, (p=0.023); however, multivariate analysis demonstrated that increasing age and the inability to awake prone were the only independent predictors of COVID-19 mortality.The mortality of patients with COVID-19 requiring respiratory support is considerable.Data from our cohort CAPRYLIC ACID PLUS managed on HDU show that CPAP and awake proning are possible in a selected population of COVID-19, and may be useful.
Further prospective studies are required.