Non-invasive respiratory support could be useful in treating COVID-19-related acute respiratory failure (ARF). A rational use of different techniques (oxygen therapy, CPAP, NIV or HFOT) by a trained pulmonologist could allow to prevent clinical aggravation and reduce the risk of ICU admission. Then, those techniques should be considered as a first line therapy outside the ICU in particular when resources are limited or if there is no immediate access to invasive ventilation.

A step-by step approach, under a strict supervision of a trained physician, must be applied to detect early and rapid aggravation.

In patients eligible for intubation. ICU team must be prevented and readily available to an immediate transfer to ICU as soon as the patient’s condition impairs.

This position paper of the Respiratory Support and Chronic Care Group of the French Society of Respiratory Diseases is intended to help respiratory clinicians involved in care of COVID-19 pandemic in the rational use of non-invasive techniques such as oxygen therapy, CPAP, non-invasive ventilation and high flow oxygen therapy in managing patients outside intensive care unit (ICU).

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