Coronavirus Disease 19 (COVID-19) can present as an Adult Respiratory Distress Syndrome (ARDS)-like pneumonia Continuous Positive Airway Pressure (CPAP) for ARDS is usually delivered in Intensive Care Units (ICU) Pressure for ICU beds led to Glasgow Royal Infirmary developing a COVID-19 High Dependency Unit (C-HDU) where domiciliary non-invasive ventilators (NIV) (Lumis 150, Resmed) with supplementary oxygen delivered CPAP for respiratory failure due to COVID-19 pneumonia We review the feasibility and efficacy of delivering CPAP outside the ICU setting Method: Retrospective analysis of data from patients receiving CPAP in C-HDU (25th March to 8th May 2020) Results: 58 patients received CPAP in total 46/58 received CPAP only 18/46 improved and were discharged by day 30 12/46 died by day 30 12/46 required mechanical ventilation - of these 6/12 successfully extubated and well at day 30, 3/12 remain in ICU and 3/12 died 4/46 failed CPAP but survived with simple oxygen therapy 12/58 did not tolerate CPAP and were switched to nasal high flow oxygen - of these 8/12 are well at day 30 Conclusions: It is feasible to deliver CPAP using domiciliary NIV machines with supplementary oxygen for COVID-19 pneumonia outwith ICU CPAP has potential to improve patient outcomes, prevent ICU admissions and deliver tangible service efficiencies C-HDU established a multi-disciplinary approach to patient care, incorporating acute medical and respiratory physicians with respiratory physiology support and developed protocols using an iterative learning approach Trials for CPAP in COVID-19 pneumonia are ongoing, but our experience supports its role and the practicality of delivering CPAP using domiciliary NIV equipment