Can lying face down help coronavirus patients breathe better? Here’s what experts say

As the fight against the novel coronavirus rages on, some doctors say they’re using a special technique to help severe COVID-19 patients breathe better.

Doctors at Long Island Jewish Hospital in New York were in the intensive care unit assessing a coronavirus patient in his 40s “to see if he needed to be put on life support,” CNN reported.

One doctor recommended the man be flipped onto his stomach — and it worked, according to the outlet. He did not have to be put on life support.

Doctors have found that placing severely ill coronavirus patients on their stomachs — called prone positioning — increases how much oxygen is getting to their lungs, CNN reported.

“We’re saving lives with this, one hundred percent,” Dr. Mangala Narasimhan told the outlet. “It’s such a simple thing to do, and we’ve seen remarkable improvement. We can see it for every single patient.”

What is prone positioning?

Prone positioning garnered some notoriety last month when author J.K. Rowling wrote on Twitter that she’d had all the symptoms of COVID-19 and that her husband — a doctor — recommended the breathing technique. Rowling wrote that it “helped a lot.”

The tweet has been liked more than 56,000 times and retweeted more than 25,000 as of April 14.

Along with her post, Rowling shared a video of Dr. Safaraz Munshi of Queen’s Hospital in Romford, England explaining how the breathing technique works.

“I want you guys to start doing this if you have the infection, right from the beginning,” Munshi says in the video.

Munshi goes on, saying to take five deep breaths, holding each for five seconds, before letting out a big cough on the sixth breath to open up airways.

After doing this cycle twice, Munshi says to lie flat on your stomach on your bed with a pillow in front of you taking breaths that are “slightly deeper than normal” for the next 10 minutes.

“You have to understand that the majority of your lung is on your back, not on your front, so by lying on your back you’re closing off more of the airways,” Munshi says in the video. “This is not good during a period of infection.”

Other doctors are quick to warn that prone positioning and controlled coughing can’t cure COVID-19 and that people with symptoms still need to contact their doctors.

“Respiratory techniques do not change the course of the disease,” Dr. Jorge Mercado told Health.

“I’m concerned that people think this is the way to cure COVID-19 because they may not use well-documented therapies when they become available,” he added. “They may also fail to seek medical help when required.”

What has prone positioning been used to treat?

Prone positioning isn’t a new treatment.

It’s been used in adult critical care wards for more than 20 years, Toronto-based respiratory therapist Thomas Piraino told Global News.

Traditionally, a patient would be placed on their stomach for 16 hours a day and then on their back for eight hours to help prevent swelling that can occur when a person stays in one position for too long, according to the outlet.

Prone positioning has also been used to treat acute respiratory distress syndrome (ARDS) since the 1970s and consistently improves oxygenation in 70% to 80% of patients, according to a study published by the U.S. National Center for Biotechnology Information.

Some patients with severe cases of COVID-19 have been known to develop ARDS.

Does prone positioning work?

A small study of 12 severely ill COVID-19 patients on ventilators in Wuhan, China, published by the American Thoracic Study found that lying face down is better for lungs, Science Daily reported.

“This study is the first description of the behavior of the lungs in patients with severe COVID-19 requiring mechanical ventilation and receiving positive pressure,” Dr. Haibo Qiu said in the study. “It indicates that some patients do not respond well to high positive pressure and respond better to prone positioning in bed (facing downward).”

According to the study, seven patients received at least one 24 hour session of prone positioning and three patients received both prone positioning and life support which replaced the function of the heart and lungs. Three patients in the study died.

“It is only a small number of patients, but our study shows that many patients did not re-open their lungs under high positive pressure and may be exposed to more harm than benefit in trying to increase the pressure,” Dr. Chun Pan said in the study. “By contrast, the lung improves when the patient is in the prone position.”

This story was originally published April 14, 2020 at 9:33 AM with the headline "Can lying face down help coronavirus patients breathe better? Here’s what experts say."