Xu DW, Li GL, Zhang JH, He F. Prone position combined with high-flow nasal oxygen could benefit spontaneously breathing, severe COVID-19 patients: A case report. World J Clin Cases 2021; 9(17): 4381-4387 [PMID: 34141804 DOI: 10.12998/wjcc.v9.i17.4381]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jun 16, 2021; 9(17): 4381-4387 Published online Jun 16, 2021. doi: 10.12998/wjcc.v9.i17.4381
Prone position combined with high-flow nasal oxygen could benefit spontaneously breathing, severe COVID-19 patients: A case report
Da-Wei Xu, Guang-Liang Li, Jiong-Han Zhang, Fei He
Da-Wei Xu, Jiong-Han Zhang, Emergency Medicine, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, Jiangsu Province, China
Guang-Liang Li, Intensive Care Unit, The Infectious Disease Control Center, Suqian 223800, Jiangsu Province, China
Fei He, Emergency Medicine, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China
Author contributions: He F and Xu DW contributed to the conception and design of the study or acquisition of data, or analysis and interpretation of data; Li GL and Zhang JH contributed to the drafting of the article or revising it critically for important intellectual content; All authors provided final approval of the version to be submitted.
Informed consent statement: Signed informed consent was obtained from the participant for publication of this report that includes details and images relating to participant.
Conflict-of-interest statement: All authors have declared that no competing interests exist.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Received: January 28, 2021 Peer-review started: January 28, 2021 First decision: March 25, 2021 Revised: April 1, 2021 Accepted: April 23, 2021 Article in press: April 23, 2021 Published online: June 16, 2021 Processing time: 117 Days and 20.8 Hours
Abstract
BACKGROUND
Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China in December 2019, the overall fatality rate of severe and critical patients with COVID-19 is high and the effective therapy is limited.
CASE SUMMARY
In this case report, we describe a case of the successful combination of the prone position (PP) and high-flow nasal oxygen (HFNO) therapy in a spontaneously breathing, severe COVID-19 patient who presented with fever, fatigue and hypoxemia and was diagnosed by positive throat swab COVID-19 RNA testing. The therapy significantly improved the patient's clinical symptoms, oxygenation status, and radiological characteristics of lung injury during hospitalization, and the patient showed good tolerance and avoided intubation. Additionally, we did not find that medical staff wearing optimal airborne personal protective equipment (PPE) were infected by the new coronavirus in our institution.
CONCLUSION
We conclude that the combination of PP and HFNO could benefit spontaneously breathing, severe COVID-19 patients. The therapy does not increase risk of healthcare workers wearing optimal airborne PPE to become infected with virus particles.
Core Tip: The outcome of severe patients with coronavirus disease 2019 (COVID-19) is poor and the effective therapy is limited. We report a case of the successful combination of the prone position and high-flow nasal oxygen therapy in a spontaneously breathing, severe COVID-19 patient. The findings showed that the co-intervention therapy benefits the patient in improving clinical symptoms, oxygenation status and radiological features of lung injury, and helps the patient avoid intubation. Additionally, it does not increase the risk that healthcare workers could become infected with virus particles.
