Tuesday March 31, 2020

Lying Face Down Improves Breathing in Severe COVID-19 Cases: Study

Chinese researchers find out how lying face down improves breathing in severe cases

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Chinese researchers have found that lying face down is beneficial and improves breathing in severe cases of COVID-19. Pixabay

In order to fight novel coronavirus (COVID-19) pandemic, which has killed more than 16,000 people globally, Chinese researchers have found that lying face down is beneficial and improves breathing in severe cases of COVID-19.

The study, published in the American Journal of Respiratory and Critical Care Medicine, revealed that lying face down was better for the lungs in patients with severe COVID-19 (SARS-CoV-2) hospitalised on ventilators.

“This study is the first description of the behaviour of the lungs in patients with severe COVID-19 requiring mechanical ventilation and receiving positive pressure,” said study researcher Haibo Qiu from Southeast University in China.

“It indicates that some patients do not respond well to high positive pressure and respond better to prone positioning in bed (facing downward),” Qiu added. The retrospective study consisted of 12 patients in Wuhan Jinyintan Hospital in China, with severe COVID-19 infection-related acute respiratory distress syndrome (ARDS) who were assisted by mechanical ventilation.

A majority of patients admitted to the ICU with confirmed COVID-19 developed ARDS, the study said. According to the researchers, the observational study took place during a six-day period the week of February 18. The clinicians in Wuhan used an index, the Recruitment-to-Inflation ratio, that measures the response of lungs to pressure (lung recruit ability). According to the findings, the research team developed this index prior to this study.

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The lung improves when the patient is in a prone position. Considering this can be done, it is important for the management of patients with severe COVID-19 requiring mechanical ventilation. Pixabay

The researchers assessed the effect of body positioning. Prone positioning was performed for 24-hour periods in which patients had persistently low levels of blood oxygenation. Oxygen flow, lung volume and airway pressure were measured by devices on patients’ ventilators. Other measurements were taken, including the aeration of their airway passages and calculations were done to measure recruit ability.

Seven patients received at least one session of prone positioning. Three patients received both prone positioning and ECMO (life support, replacing the function of heart and lungs). Three patients died, the researchers said.

Patients who did not receive prone positioning had poor lung recruit ability, while alternating supine (face upward) and prone positioning was associated with increased lung recruit ability, they added.

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“It is only a small number of patients, but our study shows that many patients did not re-open their lungs under high positive pressure and may be exposed to more harm than benefit in trying to increase the pressure,” said study researcher Chun Pan, Professor with Zhongda Hospital.

“By contrast, the lung improves when the patient is in a prone position. Considering this can be done, it is important for the management of patients with severe COVID-19 requiring mechanical ventilation,” Pan added. (IANS)

Next Story

Can TB Vaccine Fight COVID-19? Here is the Answer

TB vaccine a potential new tool to fight COVID-19: Study

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Researchers have found that Bacillus Calmette-Guerin (BCG), a vaccine for tuberculosis (TB), could be a potential new tool in the fight against the disease. Pixabay

Examining how the COVID-19 has impacted different countries, researchers have found that Bacillus Calmette-Guerin (BCG), a vaccine for tuberculosis (TB), could be a potential new tool in the fight against the disease.

The study that appeared in the pre-print repository medRxiv, proposed that national differences in COVID-19 impact could be partially explained by the different national policies respect to BCG childhood vaccination.

The BCG vaccine has existed for almost a century and is one of the most widely used of all current vaccines.

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BCG vaccine has a documented protective effect against meningitis and disseminated TB in children.

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The BCG vaccine has existed for almost a century and is one of the most widely used of all current vaccines. Pixabay

It has also been reported to offer broad protection to respiratory infections.

For the study, the researchers compared large number of countries BCG vaccination policies with the morbidity and mortality for COVID-19.

“We found that countries without universal policies of BCG vaccination (Italy, the Netherlands, the US) have been more severely affected compared to countries with universal and long-standing BCG policies,” said the study conducted by researchers from New York Institute of Technology (NYIT) College of Osteopathic Medicine in the US.

The number of confirmed coronavirus cases in the US has increased to 142,502, the highest in terms of infections globally, according to the latest tally from Johns Hopkins University’s Center for Systems Science and Engineering (CSSE).

The CSSE data showed that at least 34,026 people have died due to the disease in the country.

In Italy, which is one of the worst affected countries, 10,779 people have died due to COVID-19.

In this latest study on impact of BCG vaccination on COVID-19, researchers also found that countries that have a late start of universal BCG policy, for example, Iran had high mortality, consistent with the idea that BCG protects the vaccinated elderly population.

“There was a positive significant correlation between the year of the establishment of universal BCG vaccination and the mortality rate, consistent with the idea that the earlier that a policy was established, the larger fraction of the elderly population would be protected,” said the study.

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BCG vaccine has a documented protective effect against meningitis and disseminated TB in children. Pixabay

“For instance, Iran has a current universal BCG vaccination policy but it just started in 1984, and has an elevated mortality with 19.7 deaths per million inhabitants.

“In contrast, Japan started its universal BCG policy in 1947 and has around 100 times less deaths per million people, with 0.28 deaths. Brazil started universal vaccination in 1920 and also has an even lower mortality rate of 0.0573 deaths per million inhabitants,” the resulst showed.

Iran announced 2,901 new COVID-19 cases on Sunday as the total number of confirmed cases soared to 38,309. Also, the death toll from the disease reached 2,640 in Iran, while 12,391 patients have recovered.

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As the numbers of tuberculosis cases dropped in the late 20th century, several middle high and high-income countries in Europe dropped the universal BCG policy between years 1963 and 2010.

“The combination of reduced morbidity and mortality makes BCG vaccination a potential new tool in the fight against COVID-19,” the researchers concluded.

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Gonzalo H. Otazu of NYIT is the corresponding author of the study.

The COVID-19 death toll in Europe climbed to over 21,000 out of more than 360,000 confirmed cases. (IANS)