Prone positioning can reduce the need for intubation in people with COVID-19 who have acute hypoxaemic respiratory failure requiring high-flow nasal cannula oxygen, according to clinical trial results.

Doctors worldwide have been asking their patients with COVID-19 to lie on their stomachs to improve breathing and blood oxygen levels, but the practice has been based on scant evidence.

The study, which the researchers describe as a “meta-trial”, used data from six concurrent trials carried out at hospitals in each of six countries – Canada, US, France, Ireland, Mexico and Spain.

The patients (1121 in total) all needed respiratory support with high-flow nasal cannula for acute hypoxemic respiratory failure due to COVID-19 and were randomised to prone positioning or standard care.