Objective: To analyze the profile of patients on invasive mechanical ventilation with SARS-CoV-2 pneumonia who were pronated and who developed acute respiratory distress syndrome. Methods: Historical cohort study through the analysis of a database containing 282 patients hospitalized in a large university hospital in the city of Porto Alegre, Brazil. The population studied included individuals infected with SARS-CoV-2 and with a clinical course marked by severe pneumonia and, mainly, by acute respiratory distress syndrome, submitted to mechanical ventilation and invasive pronation maneuver. Results: Database analysis showed a high mortality rate for all patient groups and a high case fatality rate, especially in elderly patients and in individuals with active oncologic disease or with chronic kidney disease. Conclusions: The high overall mortality rate, as well as the high lethality, especially in elderly patients and in individuals with active oncologic disease or with chronic kidney disease, suggests that, for certain specific population groups, the prone maneuver is not effective in reducing high. mortality caused by acute respiratory distress syndrome associated with COVID-19.