Early prone positioning in acute respiratory distress syndrome related to COVID-19: a propensity score analysis from the multicentric cohort COVID-ICU network—the ProneCOVID study

Christophe Le Terrier , Florian Sigaud , Said Lebbah , Luc Desmedt , David Hajage , Claude Guérin , Jérôme Pugin , Steve Primmaz , Nicolas Terzi , Alain Mercat , Pierre Asfar , François Beloncle , Julien Demiselle , Tài Pham , Arthur Pavot , Xavier Monnet , Christian Richard , Alexandre Demoule , Martin Dres , Julien Mayaux , Alexandra Beurton , Cédric Daubin , Richard Descamps , Aurélie Joret , Damien Du Cheyron , Frédéric Pene , Jean-Daniel Chiche , Mathieu Jozwiak , Paul Jaubert , Guillaume Voiriot , Muriel Fartoukh , Marion Teulier , Clarisse Blayau , Erwen L’her , Cécile Aubron , Laetitia Bodenes , Nicolas Ferriere , Johann Auchabie , Anthony Le Meur , Sylvain Pignal , Thierry Mazzoni , Jean-Pierre Quenot , Pascal Andreu , Jean-Baptiste Roudau , Marie Labruyère , Saad Nseir , Sébastien Preau , Julien Poissy , Daniel Mathieu , Sarah Benhamida , Rémi Paulet , Nicolas Roucaud , Martial Thyrault , Florence Daviet , Sami Hraiech , Gabriel Parzy , Aude Sylvestre , Sébastien Jochmans , Anne-Laure Bouilland , Mehran Monchi , Marc Danguy Des Déserts , Quentin Mathais , Gwendoline Rager , Pierre Pasquier , Reignier Jean , Seguin Amélie , Garret Charlotte , Canet Emmanuel , Jean Dellamonica , Clément Saccheri , Romain Lombardi , Yanis Kouchit , Sophie Jacquier , Armelle Mathonnet , Mai-Ahn Nay , Isabelle Runge , Frédéric Martino , Laure Flurin , Amélie Rolle , Michel Carles , Rémi Coudroy , Arnaud Thille , Jean-Pierre Frat , Maeva Rodriguez , Pascal Beuret , Audrey Tientcheu , Arthur Vincent , Florian Michelin , Fabienne Tamion , Dorothée Carpentier , Déborah Boyer , Christophe Girault , Valérie Gissot , Stéphan Ehrmann , Charlotte Salmon Gandonniere , Djlali Elaroussi , Agathe Delbove , Yannick Fedun , Julien Huntzinger , Eddy Lebas , Grâce Kisoka , Céline Grégoire , Stella Marchetta , Bernard Lambermont , Laurent Argaud , Thomas Baudry , Pierre-Jean Bertrand , Auguste Dargent , Christophe Guitton , Nicolas Chudeau , Mickaël Landais , Cédric Darreau , Alexis Ferre , Antoine Gros , Guillaume Lacave , Fabrice Bruneel , Mathilde Neuville , Jérôme Devaquet , Guillaume Tachon , Richard Gallot , Riad Chelha , Arnaud Galbois , Anne Jallot , Ludivine Chalumeau Lemoine , Khaldoun Kuteifan , Valentin Pointurier , Louise-Marie Jandeaux , Joy Mootien , Charles Damoisel , Benjamin Sztrymf , Matthieu Schmidt , Alain Combes , Juliette Chommeloux , Charles Edouard Luyt (1) , Frédérique Schortgen , Leon Rusel , Camille Jung , Florent Gobert , Damien Vimpere , Lionel Lamhaut , Bertrand Sauneuf , Liliane Charrrier , Julien Calus , Isabelle Desmeules , Benoît Painvin , Jean-Marc Tadie , Vincent Castelain , Baptiste Michard , Jean-Etienne Herbrecht , Mathieu Baldacini , Nicolas Weiss , Sophie Demeret , Clémence Marois , Benjamin Rohaut , Pierre-Henri Moury , Anne-Charlotte Savida , Emmanuel Couadau , Mathieu Série , Nica Alexandru , Cédric Bruel , Candice Fontaine , Sonia Garrigou , Juliette Courtiade Mahler , Maxime Leclerc , Michel Ramakers , Pierre Garçon , Nicole Massou , Ly van Vong , Juliane Sen , Nolwenn Lucas , Franck Chemouni , Annabelle Stoclin , Alexandre Avenel , Henri Faure , Angélie Gentilhomme , Sylvie Ricome , Paul Abraham , Céline Monard , Julien Textoris , Thomas Rimmele , Florent Montini , Gabriel Lejour , Thierry Lazard , Isabelle Etienney , Younes Kerroumi , Claire Dupuis , Marine Bereiziat , Elisabeth Coupez , François Thouy , Clément Hoffmann , Nicolas Donat , Anne Chrisment , Rose-Marie Blot , Antoine Kimmoun , Audrey Jacquot , Matthieu Mattei , Bruno Levy , Ramin Ravan , Loïc Dopeux , Jean-Mathias Liteaudon , Delphine Roux , Brice Rey , Radu Anghel , Deborah Schenesse , Vincent Gevrey , Jermy Castanera , Philippe Petua , Benjamin Madeux , Otto Hartman , Michael Piagnerelli , Anne Joosten , Cinderella Noel , Patrick Biston , Thibaut Noel , Gurvan Bouar , Messabi Boukhanza , Elsa Demarest , Marie-France Bajolet , Nathanaël Charrier , Audrey Quenet , Cécile Zylberfajn , Nicolas Dufour , Buno Mégarbane (2) , Sqébastian Voicu , Nicolas Deye , Isabelle Malissin , François Legay , Matthieu Debarre , Nicolas Barbarot , Pierre Fillatre , Bertrand Delord , Thomas Laterrade , Tahar Saghi , Wilfried Pujol , Pierre Julien Cungi , Pierre Esnault , Mickael Cardinale , Vivien Hong Tuan Ha , Grégory Fleury , Marie-Ange Brou , Daniel Zafimahazo , David Tran-Van , Patrick Avargues , Lisa Carenco , Nicolas Robin , Alexandre Ouali , Lucie Houdou , Christophe Le Terrier , Noémie Suh , Steve Primmaz , Jérôme Pugin , Emmanuel Weiss , Tobias Gauss , Jean-Denis Moyer , Catherine Paugam Burtz , Béatrice La Combe , Rolland Smonig , Jade Violleau , Pauline Cailliez , Jonathan Chelly , Antoine Marchalot , Cécile Saladin , Christelle Bigot , Pierre-Marie Fayolle , Jules Fatséas , Amr Ibrahim , Dabor Resiere , Rabih Hage , Clémentine Cholet , Marie Cantier , Pierre Trouiler , Philippe Montravers , Brice Lortat-Jacob , Sebastien Tanaka , Alexy Tran Dinh , Jacques Duranteau , Anatole Harrois , Guillaume Dubreuil , Marie Werner , Anne Godier , Sophie Hamada , Diane Zlotnik , Hélène Nougue , Armand Mekontso-Dessap , Guillaume Carteaux , Keyvan Razazi , Nicolas de Prost , Nicolas Mongardon , Olivier Langeron , Eric Levesque , Arié Attias , Charles de Roquetaillade , Benjamin Chousterman , Alexandre Mebazaa , Etienne Gayat , Marc Garnier , Emmanuel Pardo , Lea Satre-Buisson , Christophe Gutton , Elise Yvin , Clémence Marcault , Elie Azoulay , Michael Darmon , Hafid Ait Oufella , Geoffroy Hariri , Tomas Urbina , Sandie Mazerand , Nicholas Heming , Francesca Santi , Pierre Moine , Djillali Annane , Adrien Bouglé , Edris Omar , Aymeric Lancelot , Emmanuelle Begot , Gaétan Plantefeve , Damien Contou , Hervé Mentec , Olivier Pajot , Stanislas Faguer , Olivier Cointault , Laurence Lavayssiere , Marie-Béatrice Nogier , Matthieu Jamme , Claire Pichereau , Jan Hayon , Hervé Outin , François Dépret , Maxime Coutrot , Maité Chaussard , Lucie Guillemet , Pierre Goffin , Romain Thouny , Julien Guntz , Laurent Jadot , Romain Persichini , Vanessa Jean-Michel , Hugues Georges , Thomas Caulier , Gaël Pradel , Marie-Hélène Hausermann , Thi My Hue Nguyen-Valat , Michel Boudinaud , Emmanuel Vivier , Sylvène Rosseli , Gaël Bourdin , Christian Pommier , Marc Vinclair , Simon Poignant , Sandrine Mons , Wulfran Bougouin , Franklin Bruna , Quentin Maestraggi , Christian Roth , Laurent Bitker , François Dhelft , Justine Bonnet-Chateau , Mathilde Filippelli , Tristan Morichau-Beauchant , Stéphane Thierry , Charlotte Le Roy , Mélanie Saint Jouan , Bruno Goncalves , Aurélien Mazeraud , Matthieu Daniel , Tarek Sharshar , Cyril Cadoz , Rostane Gaci , Sébastien Gette , Guillaune Louis , Sophe-Caroline Sacleux , Marie-Amélie Ordan , Aurélie Cravoisy , Marie Conrad , Guilhem Courte , Sébastien Gibot , Younès Benzidi , Claudia Casella , Laurent Serpin , Jean-Lou Setti , Marie-Catherine Besse , Anna Bourreau , Jérôme Pillot , Caroline Rivera , Camille Vinclair , Marie-Aline Robaux , Chloé Achino , Marie-Charlotte Delignette , Tessa Mazard , Frédéric Aubrun , Bruno Bouchet , Aurélien Frérou , Laura Muller , Charlotte Quentin , Samuel Degoul , Xavier Stihle , Claude Sumian , Nicoletta Bergero , Bernard Lanaspre , Hervé Quintard , Eve Marie Maiziere , Pierre-Yves Egreteau , Guillaume Leloup , Florin Berteau , Marjolaine Cottrel , Marie Bouteloup , Matthieu Jeannot , Quentin Blanc , Julien Saison , Isabelle Geneau , Romaric Grenot , Abdel Ouchike , Pascal Hazera , Anne-Lyse Masse , Suela Demiri , Corinne Vezinet , Elodie Baron , Deborah Benchetrit , Antoine Monsel , Grégoire Trebbia , Emmanuelle Schaack , Raphaël Lepecq , Mathieu Bobet , Christophe Vinsonneau , Thibault Dekeyser , Quentin Delforge , Imen Rahmani , Bérengère Vivet , Jonathan Paillot , Lucie Hierle , Claire Chaignat , Sarah Valette , Benoït Her , Jennifier Brunet , Mathieu Page , Fabienne Boiste , Anthony Collin , Florent Bavozet , Aude Garin , Mohamed Dlala , Kais Mhamdi , Bassem Beilouny , Alexandra Lavalard , Severine Perez , Benoit Veber , Pierre-Gildas Guitard , Philippe Gouin , Anna Lamacz , Fabienne Plouvier , Bertrand Delaborde , Aïssa Kherchache , Amina Chaalal , Jean-Damien Ricard , Marc Amouretti , Santiago Freita-Ramos , Damien Roux , Jean-Michel Constantin , Mona Assefi , Marine Lecore , Agathe Selves , Florian Prevost , Christian Lamer , Ruiying Shi , Lyes Knani , Sébastien Pili Floury , Lucie Vettoretti , Michael Levy , Lucile Marsac , Stéphane Dauger , Sophie Guilmin-Crépon , Hadrien Winiszewski , Gael Piton , Thibaud Soumagne , Gilles Capellier , Jean-Baptiste Putegnat , Frédérique Bayle , Maya Perrou , Ghyslaine Thao , Guillaume Géri , Cyril Charron , Xavier Repessé , Antoine Vieillard-Baron , Mathieu Guilbart , Pierre-Alexandre Roger , Sébastien Hinard , Pierre-Yves Macq , Kevin Chaulier , Sylvie Goutte , Patrick Chillet , Anaïs Pitta , Barbara Darjent , Amandine Bruneau , Sigismond Lasocki , Maxime Leger , Soizic Gergaud , Pierre Lemarie , Nicolas Terzi , Carole Schwebel , Anaïs Dartevel , Louis-Marie Galerneau , Jean-Luc Diehl , Caroline Hauw-Berlemont , Nicolas Péron , Emmanuel Guérot , Abolfazl Mohebbi Amoli , Michel Benhamou , Jean-Pierre Deyme , Olivier Andremont , Diane Lena , Julien Cady , Arnaud Causeret , Arnaud de la Chapelle , Christophe Cracco , Stéphane Rouleau , David Schnell , Camille Foucault , Cécile Lory , Thibault Chapelle , Vincent Bruckert , Julie Garcia , Abdlazize Sahraoui , Nathalie Abbosh , Caroline Bornstain , Pierre Pernet , Florent Poirson , Ahmed Pasem , Philippe Karoubi , Virginie Poupinel , Caroline Gauthier , François Bouniol , Philippe Feuchere , Florent Bavozet , Anne Heron , Serge Carreira , Malo Emery , Anne Sophie Le Floch , Luana Giovannangeli , Nicolas Herzog , Christophe Giacardi , Thibaut Baudic , Chloé Thill , Said Lebbah , Jessica Palmyre , Florence Tubach , David Hajage , Nicolas Bonnet , Nathan Ebstein , Stéphane Gaudry , Yves Cohen , Julie Noublanche , Olivier Lesieur , Arnaud Sément , Isabel Roca-Cerezo , Michel Pascal , Nesrine Sma , Gwenhaël Colin , Jean-Claude Lacherade , Gauthier Bionz , Natacha Maquigneau , Pierre Bouzat , Michel Durand , Marie-Christine Hérault , Jean-Francois Payen

1 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
2 OPTeN (UMR_S 1144 / U1144) - Optimisation thérapeutique en Neuropsychopharmacologie

Abstract Background Delaying time to prone positioning (PP) may be associated with higher mortality in acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19). We evaluated the use and the impact of early PP on clinical outcomes in intubated patients hospitalized in intensive care units (ICUs) for COVID-19. Methods All intubated patients with ARDS due to COVID-19 were involved in a secondary analysis from a prospective multicenter cohort study of COVID-ICU network including 149 ICUs across France, Belgium and Switzerland. Patients were followed-up until Day-90. The primary outcome was survival at Day-60. Analysis used a Cox proportional hazard model including a propensity score. Results Among 2137 intubated patients, 1504 (70.4%) were placed in PP during their ICU stay and 491 (23%) during the first 24 h following ICU admission. One hundred and eighty-one patients (36.9%) of the early PP group had a PaO 2 /FiO 2 ratio > 150 mmHg when prone positioning was initiated. Among non-early PP group patients, 1013 (47.4%) patients had finally been placed in PP within a median delay of 3 days after ICU admission. Day-60 mortality in non-early PP group was 34.2% versus 39.3% in the early PP group ( p = 0.038). Day-28 and Day-90 mortality as well as the need for adjunctive therapies was more important in patients with early PP. After propensity score adjustment, no significant difference in survival at Day-60 was found between the two study groups (HR 1.34 [0.96–1.68], p = 0.09 and HR 1.19 [0.998–1.412], p = 0.053 in complete case analysis or in multiple imputation analysis, respectively). Conclusions In a large multicentric international cohort of intubated ICU patients with ARDS due to COVID-19, PP has been used frequently as a main treatment. In this study, our data failed to show a survival benefit associated with early PP started within 24 h after ICU admission compared to PP after day-1 for all COVID-19 patients requiring invasive mechanical ventilation regardless of their severity.

Domaines: Toxicologie; Maladies émergentes; Pneumologie et système respiratoire; Maladies infectieuses; Cardiologie et système cardiovasculaire

Christophe Le Terrier, Florian Sigaud, Said Lebbah, Luc Desmedt, David Hajage, et al.. Early prone positioning in acute respiratory distress syndrome related to COVID-19: a propensity score analysis from the multicentric cohort COVID-ICU network—the ProneCOVID study. Critical Care, 2022, 26 (1), pp.71. ⟨10.1186/s13054-022-03949-7⟩. ⟨hal-03856640⟩