Recently, novel coronavirus 2019 (nCOV-19) is spreading all around the world causing severe acute respiratory syndrome (SARS-CoV-2) requiring mechanical ventilation in about 5% of infected people.

Prone position ventilation is an established method to improve oxygenation in severe acute respiratory distress syndrome (ARDS), and its application was able to reduce mortality rate.

Although the severity of critically ill patients with SARS-CoV-2 may require pronation, the huge number of patients requiring intensive care unit (ICU) admission may create management problems due to the limited number of healthcare workers compared to the number of patients.

Often, sustained oxygenation improvement can only be achieved after several cycles of pronation, with a work overload for healthcare staff.

To face these problems, we implemented a pronation protocol that allows to extend the time for the prone position beyond 16h, aiming to reduce the number of pronation cycles per patient.

Thus, the aim of this report was to assess the feasibility and efficacy of prone position ventilation beyond the usual 16h.

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