%0 Journal Article %A Aileen Kharat %A Elise Dupuis-Lozeron %A Chloé Cantero %A Christophe Marti %A Olivier Grosgurin %A Sanaz Lolachi %A Frédéric Lador %A Jérôme Plojoux %A Jean-Paul Janssens %A Paola M. Soccal %A Dan Adler %T Self-proning in COVID-19 patients on low-flow oxygen therapy: a cluster randomised controlled trial %D 2021 %R 10.1183/23120541.00692-2020 %J ERJ Open Research %P 00692-2020 %V 7 %N 1 %X Rationale and objectives Prone positioning as a complement to oxygen therapy to treat hypoxaemia in coronavirus disease 2019 (COVID-19) pneumonia in spontaneously breathing patients has been widely adopted, despite a lack of evidence for its benefit. We tested the hypothesis that a simple incentive to self-prone for a maximum of 12 h per day would decrease oxygen needs in patients admitted to the ward for COVID-19 pneumonia on low-flow oxygen therapy.Methods 27 patients with confirmed COVID-19 pneumonia admitted to Geneva University Hospitals were included in the study. 10 patients were randomised to self-prone positioning and 17 to usual care.Measurements and main results Oxygen needs assessed by oxygen flow on nasal cannula at inclusion were similar between groups. 24 h after starting the intervention, the median (interquartile range (IQR)) oxygen flow was 1.0 (0.1–2.9) L·min−1 in the prone position group and 2.0 (0.5–3.0) L·min−1 in the control group (p=0.507). Median (IQR) oxygen saturation/fraction of inspired oxygen ratio was 390 (300–432) in the prone position group and 336 (294–422) in the control group (p=0.633). One patient from the intervention group who did not self-prone was transferred to the high-dependency unit. Self-prone positioning was easy to implement. The intervention was well tolerated and only mild side-effects were reported.Conclusions Self-prone positioning in patients with COVID-19 pneumonia requiring low-flow oxygen therapy resulted in a clinically meaningful reduction of oxygen flow, but without reaching statistical significance.This randomised controlled trial analysed the effect of self-prone positioning in #COVID 19-associated pneumonia. Prone positioning was easy to implement and oxygen needs were lower in the self-prone group, although not reaching statistical significance. https://bit.ly/2MdFeyX %U https://openres.ersjournals.com/content/erjor/7/1/00692-2020.full.pdf