A life-saving COVID-19 maneuver may leave some patients, particularly older ones, with permanent nerve damage, according to a new report. The study comes from Northwestern University, where researchers have found that the use of the prone position — where a patient is placed face-down — may leave patients with an unusually high risk of troubles with their arms and legs.
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A small percentage of COVID-19 patients will develop a severe condition that leaves them unable to breathe on their own. When this happens, the patients are placed on a ventilator, which is a special medical device that helps the patient breathe until they’ve recovered enough to be removed from the machine.
Ventilators are a critical last-effort tool that can save lives, but they come with their own risks, including ventilator-associated pneumonia and irritation. According to the new study, the practice of placing COVID-19 patients in the prone position — which increases their survival odds — can result in permanent nerve damage to the arms and legs.
The number of patients found to suffer from this nerve damage is described as shocking, with study lead investigator Dr. Colin Franz stating:
It’s shocking how big a problem it is. This is a much higher percentage of patients with nerve damage than we’ve ever seen in any other critically ill population. Ordinarily, very sick people can tolerate the position that helps their breathing. But COVID patients’ nerves can’t tolerate the forces other people can generally bear.
Of the seriously ill COVID-19 patients put on ventilators, the study found that 12-percent to 15-percent are left with permanent nerve damage; it may be severe enough to leave a joint like a shoulder or wrist paralyzed. Frozen shoulder, foot drop, wrist drop, and loss of hand function are the most common outcomes in these patients, according to the study.
The damage is likely due to the way the patients are positioned. As a result, the Northwestern Memorial Hospital is tweaking the way these patients are positioned, adding padding for elbows and knees, as well as reducing pressure at the neck.