Inclusion Criteria: - All adults with suspected or confirmed COVID-19 and hypoxemia respiratory failure.  SPO2 less than 94% or Oxygen requirment of more than 5 liters. Requiring oxygen therapy in Hospital< 24 hours  Exclusion Criteria:  Clinical assessment for immediate intervention. PF<50 SF<90 RR>60bpm Hemodynamics instability with need for vasopressors. MSOF Age<18 Pregnancy Impaired LOC, agitation or lack of cooperative patient. BMI>40 Unstable spine or pelvis Abdominal wound Pnemothorax Any injury or illness that may be worsened or result in pain as a result of prone position. DNAR Any contraindicaton to prone position.