biostudies-literatureUnknown26(1)Le Terrier C<h4>Background</h4>Delaying time to prone positioning (PP) may be associated with higher mortality in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). We evaluated the use and the impact of early PP on clinical outcomes in intubated patients hospitalized in intensive care units (ICUs) for COVID-19.<h4>Methods</h4>All intubated patients with ARDS due to COVID-19 were involved in a secondary analysis from a prospective multicenter cohort study of COVID-ICU network including 149 ICUs across France, Belgium and Switzerland. Patients were followed-up until Day-90. The primary outcome was survival at Day-60. Analysis used a Cox proportional hazard model including a propensity score.<h4>Results</h4>Among 2137 intubated patients, 1504 (70.4%) were placed in PP during their ICU stay and 491 (23%) during the first 24 h following ICU admission. One hundred and eighty-one patients (36.9%) of the early PP group had a PaO₂/FiO₂ ratio > 150 mmHg when prone positioning was initiated. Among non-early PP group patients, 1013 (47.4%) patients had finally been placed in PP within a median delay of 3 days after ICU admission. Day-60 mortality in non-early PP group was 34.2% versus 39.3% in the early PP group (p = 0.038). Day-28 and Day-90 mortality as well as the need for adjunctive therapies was more important in patients with early PP. After propensity score adjustment, no significant difference in survival at Day-60 was found between the two study groups (HR 1.34 [0.96-1.68], p = 0.09 and HR 1.19 [0.998-1.412], p = 0.053 in complete case analysis or in multiple imputation analysis, respectively).<h4>Conclusions</h4>In a large multicentric international cohort of intubated ICU patients with ARDS due to COVID-19, PP has been used frequently as a main treatment. In this study, our data failed to show a survival benefit associated with early PP started within 24 h after ICU admission compared to PP after day-1 for all COVID-19 patients requiring invasive mechanical ventilation regardless of their severity.Critical care (London, England)71https://www.ebi.ac.uk/biostudies/studies/S-EPMC8944409biostudies-literatureEarly prone positioning in acute respiratory distress syndrome related to COVID-19: a propensity score analysis from the multicentric cohort COVID-ICU network-the ProneCOVID study.PMC8944409Quentin CJacquier SCalus JHraiech SAsfar PTadie JMLiteaudon JMFerriere NMentec HPichereau CHa VHTBouzat PBruna FSuh NHerault MCBeilouny BBoudinaud MCantier MLandais MFatseas JCholet CGuilmin-Crepon SFayolle PMDelbove AGalbois AVivier ELevy MAuchabie JDekeyser TNay MADinh ATLevy BNogier MBSacleux SCBaudry TThierry SAchino CJoret ABavozet FPreau SSchortgen FAmoli AMGette SRoucaud NRavan RThao GRicard JDCouadau ETeulier MBonnet NParzy GAzoulay EStoclin ABenchetrit DLambermont BPointurier VVoicu SCravoisy AGeri GBornstain CFedun YDarjent BGeorges HAmouretti MGuilbart MSharshar TVincent AMuller LRicome SHeming NRoca-Cerezo IPugin JPiagnerelli MDartevel AGirault CCadoz CDupuis CCointault OVettoretti LSchnell DSaison JPignal SCauseret AGentilhomme AChiche JDDeyme JPLe Roy CSmonig RVoiriot GRahmani IKherchache AKisoka GCombes AVivet BJeannot MRager GHarrois AMathais QBereiziat MGarcia JLazard TBougouin WBenhamida SSoumagne TKaroubi PFaure HBoiste FLe Terrier CCottrel MRolle AVimpere DChemouni FVeber BCoutrot MMichard BVinsonneau CZlotnik DAndreu PMons SLory CMorichau-Beauchant TThyrault MContou DJouan MSWeiss EGibot SWeiss NSavida ACMhamdi KDemeret SZafimahazo DPerez SLe Floch ASGoncalves BBertrand PJNguyen-Valat TMHRohaut BTrouiler PJean RHartman OGoffin PDelord BAubron CEsnault PJamme MDescamps RRosseli SBourreau ASigaud FZylberfajn CFoucault CHoffmann CGoutte SChudeau NTerrier CLPham TMassou NCharrier NPage MBodenes LCastanera JFaguer SSelves ABruneel FEbstein NHeron ACarenco LBeloncle FFontaine CHuntzinger JGregoire CIbrahim ALanaspre BThille AWCoudroy RSaladin CDemoule APoirson FBitker LQuintard Hde Roquetaillade CGevrey VAubrun FMootien JLena DMercat ABruneau AJandeaux LMDe La Chapelle ADubreuil GPlouvier FKimmoun AHamada SRazazi KJacquot AGaudry SCasella CLavalard AElaroussi DJochmans SBourdin GPayen JFGrenot RBajolet MFPasquier PLouis GHierle LGarin ADopeux LDegoul SHajage DChaignat CCapellier GDres MOrdan MARivera CEtienney IGodier ATerzi NNeuville MGiacardi COutin HHinard SAvargues PCoupez EChrisment ACOVID-ICU Group on behalf of the REVA Network and the COVID-ICU InvestigatorsSchenesse DMonard CThill CVinclair MDeye NGuitard PGSchmidt MVinclair CBouniol FJoosten AMontravers PLuyt CESatre-Buisson LRoger PAPlantefeve GLesieur OBeurton ASen JEhrmann SMacq PYDellamonica JMazzoni TDevaquet JLaterrade TPasem AGergaud SStihle XAttias AGaci RLejour GAssefi MDemarest EDepret FHausermann MHBerteau FEmmanuel CBigot CMichelin FGandonniere CSCarpentier DBlot RMRunge IBenzidi YLombardi RCardinale MLamacz ABonnet-Chateau JGouin PBayle FLepecq RDesmedt LHayon JFrat JPHer BBlayau CSaccheri CGarnier MPene FJadot LKouchit YSerpin LLangeron ODiehl JLBoukhanza MMazeraud ADemiselle JLevesque EGuerot ELeger MSauneuf BAndremont OLecore MDesmeules IBruel CPeron NMegarbane BAbraham PJean-Michel VBesse MCNseir SBiston PFilippelli MDurand MGissot VChillet PTextoris JPardo EHazera PSaghi TKerroumi YDarmon MPalmyre JLacherade JCMayaux JEgreteau PYHerzog NTubach FMoyer JDMathieu DChousterman BGCarteaux GPascal MFlurin LGuitton CAlexandru NYvin EPradel GMonsel APernet PFrerou AHage RCarreira SFerre AKuteifan KMekontso-Dessap AL'Her EPaillot JDebarre MCharron CHerbrecht JENoublanche JBeuret PBaudic TFreita-Ramos SJaubert PDeserts MDDArgaud LBouar GLEGutton CBruckert VDlala MBobet MRusel LCohen YCastelain VRimmele TSement APutegnat JBMasse ALAmelie SQuenet ALancelot ASchaack EFleury GSztrymf BMarcault CTientcheu AChommeloux JDauger SAnnane DDemiri SVan Vong LRobaux MASetti JLDelforge QNougue HLeloup GDaniel MPillot JLemoine LCJallot APujol WSumian CBoyer DColin GCaulier TFloury SPDe Prost NMahler JCDufour NLabruyere MJozwiak MValette SHariri GSylvestre ABegot EDaubin CDu Cheyron DLeclerc MAnghel RLavayssiere LBouchet BViolleau JThouny RPainvin BHauw-Berlemont CMongardon NPommier CLacave GMadeux BMebazaa ALemarie PPavot ATran-Van DGayat ELortat-Jacob BGuillemet LPaulet RPrevost FGallot RWiniszewski HPitta ADarreau CBouteloup MVezinet COufella HABougle AMartino FEmery MBionz GTachon GShi RLebas ELamer CMarchalot AConrad MHoudou LNoel CMontini FResiere DConstantin JMNoel TLucas NPerrou MBurtz CPCollin AAvenel AChelha RDuranteau JDamoisel CCady JMoine PRepesse XBouilland ALGros AMathonnet AMaquigneau NLa Combe BMarsac LCarles MRoth CSahraoui AAbbosh NFeuchere PPajot ODelignette MCSma NLamhaut LTanaka SBarbarot NPrimmaz SPersichini ROuchike AFartoukh MWerner MGiovannangeli LUrbina TBlanc QJung CRichard CSanti FDargent AChaussard MDaviet FMattei MRoudau JBMonchi MLe Meur ARamakers MRobin NChapelle TDonat NMazerand SPoupinel VGauthier CChelly JGuntz JRey BCracco CChaulier KRoux DGarcon PTrebbia GMaestraggi QMonnet XGeneau IBrou MABenhamou MMaiziere EMBergero NTamion FPoignant SGuerin CLegay FRodriguez MOuali AGauss TLebbah SVieillard-Baron ASchwebel CGarrigou SGalerneau LMMarchetta SKnani LRouleau SBrunet JFillatre PPetua PCungi PJCharrrier LCailliez PCourte GOmar EMalissin IDhelft FBaron EMoury PHDelaborde BPPoissy JMarois CThouy FMazard TGobert FChaalal APiton GQuenot JPCharlotte GBaldacini MLasocki SSerie MfalseEarly prone positioning in acute respiratory distress syndrome related to COVID-19: a propensity score analysis from the multicentric cohort COVID-ICU network-the ProneCOVID study.<h4>Background</h4>Delaying time to prone positioning (PP) may be associated with higher mortality in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). We evaluated the use and the impact of early PP on clinical outcomes in intubated patients hospitalized in intensive care units (ICUs) for COVID-19.<h4>Methods</h4>All intubated patients with ARDS due to COVID-19 were involved in a secondary analysis from a prospective multicenter cohort study of COVID-ICU network including 149 ICUs across France, Belgium and Switzerland. Patients were followed-up until Day-90. The primary outcome was survival at Day-60. Analysis used a Cox proportional hazard model including a propensity score.<h4>Results</h4>Among 2137 intubated patients, 1504 (70.4%) were placed in PP during their ICU stay and 491 (23%) during the first 24 h following ICU admission. One hundred and eighty-one patients (36.9%) of the early PP group had a PaO₂/FiO₂ ratio > 150 mmHg when prone positioning was initiated. Among non-early PP group patients, 1013 (47.4%) patients had finally been placed in PP within a median delay of 3 days after ICU admission. Day-60 mortality in non-early PP group was 34.2% versus 39.3% in the early PP group (p = 0.038). Day-28 and Day-90 mortality as well as the need for adjunctive therapies was more important in patients with early PP. After propensity score adjustment, no significant difference in survival at Day-60 was found between the two study groups (HR 1.34 [0.96-1.68], p = 0.09 and HR 1.19 [0.998-1.412], p = 0.053 in complete case analysis or in multiple imputation analysis, respectively).<h4>Conclusions</h4>In a large multicentric international cohort of intubated ICU patients with ARDS due to COVID-19, PP has been used frequently as a main treatment. In this study, our data failed to show a survival benefit associated with early PP started within 24 h after ICU admission compared to PP after day-1 for all COVID-19 patients requiring invasive mechanical ventilation regardless of their severity.2022-01-01T00:00:00Z2022 Mar2024-11-20T05:56:48.352Z2024-11-20T05:56:48.352ZS-EPMC89444093533133210.1186/s13054-022-03949-7