Potential Prophylactic and Therapeutic Effects of Respiratory Physiotherapy for COVID-19.

New coronavirus disease 2019 (COVID-19) has succeeded in surprising the world with infecting more than 12 million people and claiming 560,000 lives in only six months. COVID-19 is associated with a spectrum of respiratory symptoms, especially dyspnea. Patients who progress to severe or critical condition display peripheral and posterior lung lesions bilaterally. These patients require admission to the intensive care unit (ICU); therefore, they are prone to ICU-related complications during disease and after recovery. Respiratory physiotherapy techniques, in particular, active techniques, might help the improvement of airway clearance and lung capacity in addition to the reduction of breathing effort during the active disease. In parallel, it might lead to the prevention of disabilities, resulting from infection and extended hospitalization in patients who recovered from COVID-19. This supports physiotherapy both as a prophylactic and therapeutic strategy for COVID-19.

Cardiovascular system is at higher risk of affecting by COVID-19.

SARS-CoV-2 has shown its potential to cause severe manifestations among individuals with underlying cardiovascular disease (CVD). The patients infected with SARS-CoV-2 with pre-existing CVD are more likely to relapse. There are several reasons, including the prolonged hospitalization time as a consequence of their more severe illness and aberrant expression of angiotensin-converting enzyme 2 (ACE2) - the cell surface receptor of SARS-COV2 that is present on cardiac cells - and using drugs such as ACE inhibitors and angiotensin receptor blockers (ARBs) that alter the expression of ACE2. Besides, SARS-CoV-2 shares structural similarities with SARS-CoV-1, and that patients recovered from SARS-CoV1 have shown an increased risk of developing inflammatory, metabolic, and cardiac diseases. It makes some concerns that people who recovered from SARS-CoV2 are also liable to develop these chronic conditions later. Further studies should investigate the probability of recurrence of COVID-19 in patients with CVD and the development of approaches for the prevention of chronic inflammatory conditions in patients with CVD who recovered from COVID-19.