Lying face-down could improve breathing in severe coronavirus cases, studies suggest

Throughout the coronavirus pandemic, doctors have reported success in treating patients who were having trouble breathing by shifting them into prone — or face-down — position. Two recent small studies appear to back up their intuitions.

One study published by JAMA Internal Medicine last week found that out of 25 non-intubated COVID-19 patients with severe respiratory symptoms in New York City who spent at least one waking hour in prone position, 19 saw their oxygen saturation improve to 95 percent or greater, which lowered the risk of more invasive ventilation methods.

A similar study published in The Lancet last week monitored 56 patients with COVID-19-related pneumonia in Manza, Italy, 47 of whom were able to be repositioned. Researchers found that prone positioning was "feasible and effective in ameliorating blood oxygenation in awake patients." Upon returning to a supine, or face-up position, 23 of those patients maintained their improved breathing. The study didn't find a significant difference in the rate of intubation between those who responded to prone positioning and those who didn't.

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Both studies were small and acknowledge the hypothesis warrants further examination, including randomized trials, but coupled with the anecdotal success doctors have reported, the researchers suggest repositioning could be a simple, safe, and useful mitigation method. Read the results of the studies at The Lancet and JAMA Internal Medicine.