Awake Prone Position for Early hypoxemia in COVID-19
- Adult patient (> 18 years old)
- Admission to the medical wards or planned admission to the medical wards from the ED within the previous 24 hours (not ICU)
- Confirmed COVID-19 infection or under evaluation for COVID-19
- Have access to their own functioning smartphone that can connect to the internet and receive text messages in the hospital room
- Ability to read simple instructions and answer simple written questions
Prone positioning is a well-studied and validated treatment for severe acute respiratory distress syndrome (ARDS). However, there are no randomized studies on the use of prone positioning in the non-intubated patient. It is unknown if this intervention would be helpful in preventing further respiratory deterioration in terms of increasing supplemental oxygen requirements, endotracheal intubation, and ICU admission.
The Awake Prone Position for Early hypoxemia in COVID-19 (APPEX-19) Study is a pragmatic adaptive randomized controlled unblinded trial. APPEX-19 randomizes non-ICU patients with COVID-19 or who are under evaluation for COVID-19 to lie in a prone position (i.e, with their stomach and chest facing down) or to usual care.