الفهرس 
COVID-19Only 14 pages are availabe for public view
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Abstract
The coronavirus family has four common human coronaviruses (229E, NL63, OC43, HKU1) associated with the common cold, and three strains are associated with pneumonia, respiratory failure, and death, including SARS-CoV (severe acute respiratory syndrome coronavirus), MERS-CoV (Middle Eastern respiratory syndrome coronavirus), and SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2).The novel coronavirus, SARS-CoV-2, was first described in December 2019 in patients in Wuhan, China who developed severe pneumonia, and was named coronavirus-19 disease (COVID-19) by the World Health Organization on February 11, 2020.
Symptoms of SARS-CoV-2 include fever, cough, shortness of breath, chills, repeated shaking with chills, muscle pain, headache, sore throat, loss of taste or smell, anorexia, nausea, vomiting, abdominal pain, and/or diarrhoea.
Patients with SARS-CoV-2 are at risk for acute respiratory distress syndrome, the main cause of death.
The COVID-19 pandemic has led to a substantial increase in the number of patients admitted to hospital with respiratory failure. Most of these patients require non-invasive ventilatory support; however, the failure rate (i.e., worsening of condition or lack of improvement) is extremely high and intubation is often necessary, rapidly saturating resources and the availability of intensive care unit (ICU) beds, potentially leading to increased mortality.
Acute respiratory distress syndrome (ARDS) is a major complication of COVID-19 that occurs in 20–41% of patients with severe disease. Treatment of ARDS requires tracheal intubation and mechanical ventilation, and patients can benefit from prone positioning, which has
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been shown to improve oxygenation and reduce mortality in non-COVID-19-related ARDS.
Despite ongoing pharmacological trials, the treatment of patients with Coronavirus disease 2019 (COVID-19) pneumonia and moderate-to-severe respiratory failure remains supportive, with up to 60% of these patients requiring invasive mechanical ventilation and suffering from a mortality ranging 40–81%.
Prone positioning (PP) therapy is a non-pharmacological treatment which ameliorates oxygenation through several mechanisms, including improved ventilation/perfusion matching, relief of the compression of dependent lung regions from mediastinum’s weight, and change in chest wall elastance. Furthermore, PP showed benefits independently of its effects on gas exchange.
The main aim of this study was to investigate the role of prone positioning in improvement of oxygenation and mortality rates in non-intubated SARS-CoV-2 patients associated with hypoxemic Acute Respiratory Failure.
This Prospective study conducted at Abo Hommos Central Hospital and Abo-Qir Specialized Hospital from June 2020 to august 2020. This study involved 100 patients subdivided into two subgroups at random. group I: 50 patients in prone position, group II: 50 patients in supine position and both groups continuously monitored for oxygen saturation.
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The main results of the study revealed that:
No significant difference between the two studied groups regarding age, sex and BMI.
There is significant difference was found between the studied groups regarding DM, smoking and dyslipidemia.
There is no significant difference between the two studied groups regarding heart rate, RR, SBP and DBP.
There is no significant difference between the two studied groups regarding laboratory parameters.
There is no significant difference found between the two studied groups regarding severity according to CO-RADS.
There is a significant difference found between the two studied groups regarding PO2 after.
There is a significant decrease in PCO2 and dyspnea while there is a significant increase in PO2 and discomfort.
Responders were more prevalent in prone group compared to supine group but without statistically significant difference.
Risk for intubation was significantly lower among prone group compared to supine group.
Mortality rate was significantly lower among prone group compared to supine group.
There is no significant difference found between the two studied groups regarding complications.
Prone position significantly reducing intubation rate among Patients with SARS-COV-2 associated with hypoxemic acute respiratory failure.