Lying face down might help more COVID-19 patients

Prone positioning, or lying face down, might be useful for severely ill COVID-19 patients who can still breathe on their own, early data suggests.

Lying face down makes it easier for the lungs to deliver oxygen to the blood.

The position is often used in COVID-19 patients on mechanical ventilators, but it is not without risks. Until the pandemic, it was not used in patients who were not intubated, even if they had low oxygen levels. In a report on Wednesday in CMAJ, researchers say evidence is emerging that hospitalized COVID-19 patients who are awake and breathing on their own might benefit.

Their review of published data found that studies so far have been small, and randomized trials are needed to clarify the benefits and risks in COVID-19 patients, they advise.

Earlier this year, Dr. Sanja Jelic of Columbia University Medical Center told Reuters she would not recommend prone positioning at home.

“Lay people may not be able to assess accurately whether somebody has altered mental status or is too weak for this maneuver,” she said.

“Patients need to have intact mental status and be able to turn themselves in bed without assistance. Being in prone position while confused or lethargic may increase the risk for aspiration and possibly worsen already low oxygen levels.”