The Down Side of Prone Positioning: The Case of a Coronavirus 2019 Survivor

Am J Phys Med Rehabil. 2020 Oct;99(10):870-872. doi: 10.1097/PHM.0000000000001530.

Abstract

The coronavirus 2019 pandemic has resulted in a surge of patients with acute respiratory distress syndrome. Prone positioning may be used in such patients to optimize oxygenation. Severe infections may leave survivors with significant functional impairment necessitating rehabilitation. Those who have experienced prolonged prone positioning are at increased risk for complications not typically associated with critical illness. This case report describes the course and clinical findings of a survivor of acute respiratory distress syndrome due to coronavirus 2019 who was prone positioned while in intensive care and subsequently admitted to an inpatient rehabilitation facility. Her related complications, as well as those described in the literature, are reviewed. Critical elements of a comprehensive rehabilitation treatment plan for those who have been prone positioned, including implementation of preventive strategies, as well as early recognition and treatment of related injuries, will be described.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / physiopathology*
  • Coronavirus Infections / rehabilitation
  • Coronavirus Infections / virology
  • Critical Care / methods*
  • Female
  • Humans
  • Pandemics
  • Patient Positioning / adverse effects*
  • Pneumonia, Viral / physiopathology*
  • Pneumonia, Viral / rehabilitation
  • Pneumonia, Viral / virology
  • Prone Position*
  • Respiratory Therapy / methods*
  • SARS-CoV-2