Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome. It a cluster of cases of pneumonia of unknown cause that appeared in the city Wuhan, Hubei province in China in 2019. Globally, the total case of coronavirus disease has exceeded 26million infection cases recorded. Most people with COVID-19 have no symptoms or only end up with a mild illness. About 12 per cent of the people are admitted to hospital and one in five of those individuals end up in ICU.
The role of a physiotherapist
Amongst health-care workers, physical-therapists especially respiratory therapists, are also playing an important role in managing and caring for novel COVID-19 patients. They are involved in patient assessment, conservative care, posture correction, mobilization and while training to wean of from the weaning from invasive mechanical ventilator support. To do this Physiotherapist work alongside large multidisciplinary team (PCD) of active hospital services and intensive care unit. Physiotherapy may be useful in the treatment of respiration, in the treatment of COVID-19, in addition to proven work to prevent or delay intensive care.
Respiratory care
Many patients who have severe respiratory failure as a result of COVID-19 need to be on a breathing machine. Some require proning or turning them onto their tummy which is a way to help people clear their lungs, as well as improve lung capacity and oxygen levels. A further key element of a physiotherapist’s role in intensive care is improving a patient’s lung function. Physiotherapist treatment also includes:
• Postural infiltration, respiratory exercise.
• Reduce unnecessary respiratory activities.
• Gradual mobilization and increasing physical activity tolerance.

Recovery Rehabilitation
Studies have shown that patients who end up in intensive care, in coma and on a breathing machine for a long period of time are more likely to suffer long term problems from their illness. This condition is referred to as Post Intensive Care Syndrome (PICS) which includes physical weakness, cognitive and psychological effects. An important part of a physiotherapist’s role is to help rehabilitate these patients. That means doing exercises, as well as sitting up and walking with these patients. Early rehabilitation and mobilisation involve helping to get patients up and moving and to facilitate their discharge from intensive care and hospital as quickly as possible. Physiotherapy sessions can include
• ROM exercises, dynamic walking exercises and breathing.
• Develop an individual training program that depends on the patient’s endurance.

The role of a physiotherapist is crucial in limiting the discomfort and promoting patients recover. After discharge from the hospital, they are still far from what is normal for them. Persistent fatigue, breathlessness and ongoing pain are some of the recognized key challenges for patients with COVID-19 who were hospitalized for a long period of time. Those who have ongoing symptoms must ensure access to rehabilitation support beyond the hospital stay.