Prone Positioning in Non-Intubated Patients With COVID-19 Outside of the Intensive Care Unit: More Evidence Needed

Disaster Med Public Health Prep. 2020 Aug;14(4):e22-e24. doi: 10.1017/dmp.2020.267. Epub 2020 Aug 20.


The coronavirus disease (COVID-19) pandemic has brought the Italian National Health System to its knees. The abnormally high influx of patients, together with the limited resources available, has forced clinicians to make unprecedented decisions and provide compassionate treatments for which little or no evidence is yet available. This is the case for the use of noninvasive positive pressure ventilation and continuous airway pressure ventilation, combined with prone position in patients with COVID-19 and acute respiratory distress syndrome treated outside of intensive care units. In our article, we comment on the evidence available, so far, and provide a brief summary of data collected at our health institution in Piedmont, Italy.

Keywords: COVID-19; continuous airway pressure ventilation; noninvasive mechanical ventilation; prone positioning.

MeSH terms

  • Adult
  • Aged
  • COVID-19 / epidemiology
  • COVID-19 / physiopathology
  • COVID-19 / therapy*
  • Continuous Positive Airway Pressure / standards*
  • Continuous Positive Airway Pressure / statistics & numerical data
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Pandemics / statistics & numerical data
  • Patient Positioning / methods
  • Patient Positioning / standards*
  • Patient Positioning / statistics & numerical data
  • Prone Position / physiology*