A meta-analysis reported in Lancet Respiratory Medicine stated that the awake prone positioning reduced the need for intubation in selected patients with severe COVID-19. 

The meta-analysis included data from a 2021 meta-trial with a total of more than 1,000 COVID-19 patients, mostly in ICU, which found awake prone positioning to decrease the need for intubation. It also included data from 7 RCTs which did not find a difference in intubation risk among almost 700 patients on conventional oxygen therapy. A total of 29 studies were included in the review, with ten RCTs (1985 patients) and 19 observational studies (2669 patients). In ten RCTs, awake prone positioning significantly reduced the need for intubation in the overall population, compared to supine position, especially among those patients who received advanced respiratory support at enrolment (RR 0•83 [0•71–0•97]) and those in the intensive care unit (ICU) (RR 0•83 [0•71–0•97]). No reduction was seen in patients receiving conventional oxygen therapy (RR 0•87 [0•45–1•69]) or in non-ICU settings (RR 0•88 [0•44–1•76]).

The study concluded that awake prone positioning should be encouraged among COVID-19 patients with acute hypoxemic respiratory failure, especially when the patients are in ICU and need advanced respiratory support. (MedPage Today, March 17; Lancet Respiratory Medicine, March 16, 2022)