Awake Prone Positioning in Sars-CoV-2 (Covid-19) Non-Intubated Patients with Acute Respiratory Failure in Adult Population: A Literature Review

Objective: This article aims to review the current evidence in Covid-19 patients with acute respiratory failure who required awake prone positioning as a therapeutic intervention. I searched the literature on MEDLINE, PubMed, Cochrane Library, Google Scholar, and other databases. I found several studies that analyzed and shared the data regarding awake prone positioning in the Covid-19 patients, with duration ranging from 12-16 hours. I found that the major criteria used included PaO2/FiO2 ratio, SpO2/FiO2, respiratory rate, heart rate. I also searched the suggested indications, contra-indications, complications, and outcomes of those patients. Awake proning showed improvement in lung mechanics and oxygenation, but no benefit in outcome in the majority of studies. Currently, the data is unclear to determine the overall benefit. Further controlled trials are needed.