Critical Respiratory Dysfunction And Role Of Chest Physiotherapy In Sars Cov-2 Pandemic: A Case Series

Abstract

COVID-19 is a serious burden on the health care workers, administration and government on critical care resources due to large burden of cases requiring critical care. The spectrum of disease ranges from influenza like illness to fever, cough, fatigue, sputum production and shortness of breath. Early intervention with chest physiotherapy can prevent the need for intubation in COVID-19 patients with respiratory distress. Seven cases from ICU and Eight cases from the Isolation ward were selected for current study. All cases were RT-PCR positive. The patients were assessed for the SPO2 levels, Level of dyspnea, Anxiety and depression levels by Hospital anxiety and depression scale (HADS) pre intervention and post intervention. After the physiotherapy sessions, it was observed that the recovery is speeded and the patients anxiety and depression levels also decreased with increase in self-esteem and confidence in these cases. . As we know that the COVID-19 cases suffer from dyspnea, reduced rate and depth of respiration, weakness, anxiety and depression which can increase the risk of mortality. by designing individualized treatment protocols for a better outcome. The SARS-CoV-2 cases (N=15) were selected from ICU and Isolation ward following a recommendation for physiotherapy by senior physicians from Level 3 COVID hospital in Uttar Pradesh, India. Both males (N=13) and females (N=2) cases were selected for the study. An informed consent was taken from these subjects. Seven cases from ICU and eight cases from Isolation ward were selected for this study. All 15 cases were RT-PCR positive. The cases were assessed for the SPO2 levels, Level of dyspnea, anxiety and depression Early physiotherapeutic interventions in the form of NPF, PNF, ACBT, Accupressure, Aerobic activities improved the respiratory health along with reduction in anxiety and depression may result in good outcome in these cases. Early Physiotherapy when given regularly can avoid the need for mechanical ventilation, thus can prevent mortality in COVID-19 patients. Hence, early interventional physiotherapy can be incorporated in the scheduled treatment protocols of COVID-19 patients globally.