Respiratory failure & ventilation
Effect of early and later prone positioning on outcomes in invasively ventilated COVID-19 patients with acute respiratory distress syndrome: analysis of the prospective COVID-19 critical care consortium cohort study
An erratum to this article was published (Ann Intensive Care, 28 Mar 2025 ↗)
Authors' conclusion
Prone positioning is associated with improved outcomes in patients with COVID-19, but timing matters. We found no association between later proning and patient outcome.
Study context
- Population
- Invasively ventilated COVID-19 patients with ARDS, COVID-19 Critical Care Consortiumwith prone positioning data
- Participants
- 3,131 participants
- Exposure
- Never proned vs Proned within 48 h vs Proned after 48 h
- Never pronedn = 1,482reference
- Proned within 48 hn = 1,034
- Proned after 48 hn = 615
- Outcome
- Mortality
- Follow-up
- 28 and 90 days
Methodological detailsmulticentre consortium
- Multicentre consortium
Main finding
As reported in the abstract
Proned within 48 h vs Never pronedHazard ratio (95% CI)P value
28-day mortality
0.82(0.68–0.98)
P = 0.0390-day mortality
0.81(0.68–0.96)
P = 0.02- Prone positioning after 48 h, 28-day mortality: HR (95% CI 0.75, 1.14), p = 0.47; no statistically significant association
- 0.93
- Prone positioning after 48 h, 90-day mortality: HR (95% CI 0.78, 1.16), p = 0.59; no statistically significant association
- 0.95
Observational data: associations, not effects.
Original publication
Effect of early and later prone positioning on outcomes in invasively ventilated COVID-19 patients with acute respiratory distress syndrome: analysis of the prospective COVID-19 critical care consortium cohort study. Ann Intensive Care. Published 10 February 2025. doi:10.
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