The Relationship between Pulmonary Embolism and prone position among COVID-19 Patients in King Abdulaziz Medical City

Authors: Alotaibi, Dhaifallah, Alkhalidi, Abdulmajeed, Ismaiel, Yassen, Almodhish, Yazeed, Althyab, Hatim, Aldhoayan, Ibrahim, Alanazi, Reem, Alsubaie, Atheer

Country: Saudi Arabia

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Abstract: Abstract
Background: Corona virus disease 19 (COVID-19) is a disease caused by SARS-CoV-2 virus, where is the majority of infected individuals will have mild respiratory symptoms. Prone position is used to correct ventilation-perfusion mismatch by increasing the flow of air and blood to the dorsal region of the lung lifting the weight of the heart and abdominal compartments. Patients with COVID-19 are at high risk of developing pulmonary embolism (PE), which can result in one-third of severely ill COVID-19 patients who need intensive care units (ICUs) admission.
Objectives: To study the relationship between pulmonary embolism and prone position among COVID-19 patients in King Abdulaziz Medical City.
Method: 383 patients in adult critical care units enrolled to the study and were divided to control group and prone position group. CT angiography, D dimer tests, total hours of prone positioning and mortality data was collected for both groups. Non probability convenience sampling was used to select the samples. Pearson Chi square test and Fisher Exact test was used for analysis of data with significance level at 5%.
Results: A total of 383 patients enrolled to this study, 290 (75.7%) were male and 93 (24.3%) were female. 150 (43.4%) did prone position comparing to 195 (56.5%) did not do prone position. The median (IQR) in years, total hours of prone position and length of stay in ICU (in days) were 56(45,63), 20.5(8.5, 48) and 9(4, 17), respectively. Out of 150 samples with prone position only 12 (8%) had Pulmonary Embolism of which 11 (91.7%) were alive and was statistically significant with p value 0.020. Whereas in the non prone position (control) group the mortality rate was 16.7% which was higher as compared to those in prone position P= 0.236) (Table 1). Moreover, 95 (97.9) patients tested positive on the final D-dimer test acquired were expired (Statistically significant, p= 0.001) comparing to the first D-dimer result which found to be not conclusive (p= 0.142). Relation of total hours of prone position with either incidence of PE or mortality were not statistically significant (p= 0.732, p= 0.200, respectively).
Conclusion: in summary, there is a significant relationship between prone position and pulmonary embolism. Mortality rate between patients in prone position group who were diagnosed with PE was 8.3% comparing to 16.7% in non-prone group. The extra precaution during COVID pandemic prevented the possibility of testing patients for CT angiography which we believe that it is considered as a limitation of this study.

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Paper Id: 231302

Published On: 2024-10-10

Published In: Volume 12, Issue 5, September-October 2024

Cite This: The Relationship between Pulmonary Embolism and prone position among COVID-19 Patients in King Abdulaziz Medical City - Alotaibi, Dhaifallah, Alkhalidi, Abdulmajeed, Ismaiel, Yassen, Almodhish, Yazeed, Althyab, Hatim, Aldhoayan, Ibrahim, Alanazi, Reem, Alsubaie, Atheer - IJIRMPS Volume 12, Issue 5, September-October 2024.

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