Successful recovery from COVID-19 pneumonia with awake early self-proning

Abstract

Background: Since COVID-19 global pandemic, "early awake proning in non-intubated patients with COVID-19" has been suggested as anecdotal evidence. Hereby, we report an awake and non-intubated patient with COVID-19 pneumonia who was successfully managed with early self-proning. Case presentation: A 68-year-old male presented to the emergency department with a respiratory distress. He was non-smoker and denied any significant past medical history. His chest computed tomography scan showed "ground glass opacities" and "consolidation areas" located especially in the peripheral sites of both lungs which were consistent with a coronavirus pneumonia and reverse transcription polymerase chain reaction amplification by a nasopharyngeal swab sample for SARS-Cov-2 was also positive. His initial therapy with hdroxychloroquine and favipiravir was started. Due to deterioration of the patient's oxygenation, he was transferred to the intensive care unit for further treatment with non-invasive mechanical ventilation on supine position and intermittent "awake early self-proning positioning" was applied. Additionally, antibiotherapy, anticoagulant therapy, and convalescent plasma therapy were also administered to the patient. On the 17th day of the ICU admission, he was transferred back to the ward. And the patient was discharged from the hospital on the 19th day of his initial admission. Conclusions: Although some case reports and small case series initially noted potential improvement in oxygenation by awake proning, further research is required to evaluate the exact benefits and proper applications of prone positioning in awake patients with COVID-19 pneumonia.