Effect of Priority and Delay of Prone Positioning and Chest Physiotherapy on Respiratory Outcomes in Patients with COVID-19: A Randomized Clinical Trial

Background: COVID-19, caused by the SARS-CoV-2 virus, is a novel coronavirus that has led to a global pandemic. Physiotherapy is among the beneficial treatments for this disease. This study investigated the impact of the priority and delay of prone positioning and chest physiotherapy (CPT) on patients with COVID-19. Methods: A randomized clinical trial was conducted involving 26 COVID-19 patients who were randomly assigned to two groups: one group prioritizing prone positioning over chest physiotherapy (comprising seven men and six women, with an average age of 67.46 ± 5.91) and the other group prioritizing CPT over prone positioning (comprising eight men and five women, with an average age of 68.38 ± 5.85). Respiratory outcomes, including SpO2, PaO2, FiO2, FEV1, and FVC, were measured using pulse oximetry, arterial blood gas analysis (ABG), and spirometry). FEV1/FVC and SpO2/FiO2 ratios were evaluated both before and after the intervention Results: The demographic characteristics of the patients and the baseline respiratory outcomes between the two groups did not exhibit significant differences (P > 0.05). A significant difference was observed in respiratory outcomes within each group before and after the intervention (P < 0.05). However, after the intervention, there were no significant differences between the two groups in terms of respiratory outcomes (P > 0.05) Conclusion: Both prioritizing prone positioning over CPT and prioritizing CPT over prone positioning appeared to improve each respiratory outcome. Nevertheless, it was not observed that prioritizing or delaying prone positioning and CPT improved respiratory outcomes in patients with COVID-19.