ACUTE AND POST-ACUTE PHYSIOTHERAPY AND REHABILITATION IN COVID-19 INFECTION

Abstract

COVID-19 infection emerged in Wuhan, China, in December 2019, and has been active all over the world, especially Europe. About 80% of patients develop mild to moderate disease without pneumonia. The severe disease develops in 14% of viral pneumonia cases. The respiratory condition of some patients continues to deteriorate gradually and develops acute respiratory distress syndrome (ARDS) requiring mechanical ventilation support that usually lasts up to the third week. At COVID-19 acute phase, applications increasing work of breathing and respiratory distress (airway clearance techniques, breathing exercises, exercise training, and respiratory muscle training) are not recommended. The approaches suggested in these patients are positioning and mobilization that can be applied based on sedation and clinical status. In case of contact with patients with a definite/potential COVID-19 infection, the Turkish Ministry of Health's standard contact and droplet infection protection measures must be followed and personal protective equipment has to be used. During the post-acute period, based on the current limited information, prolonged mechanical ventilation and intensive care unit stay, and respiratory, cardiovascular, neurologic, muscular and metabolic effects of COVID-19, together with the comorbid conditions, individualized low level of activity and exercise may be suggested. COVID-19 infection is at the 100th day in the world and the 30th day in Turkey. There is a very rapid and dramatic change in the information and recommendations. This review has been written to guide acute and post-acute physiotherapy and rehabilitation in COVID-19 infection.