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CASE REPORT
Year : 2021  |  Volume : 15  |  Issue : 1  |  Page : 50-54

Pathway to discharge following COVID-19 in an obese female with multiple comorbidities: Does physiotherapy play a pivotal role?


1 Physiotherapy School and Centre, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
2 Department of Medicine, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Shivam N Chopra
Physiotherapy School and Centre, Seth G.S. Medical College and KEM Hospital, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/PJIAP.PJIAP_43_20

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From Wuhan to India, the severe acute respiratory syndrome coronavirus-2 or COVID-19 presentations ranged from completely asymptomatic to severe respiratory failure requiring intensive care. Patients with associated morbidities such as obesity, hypertension, and diabetes were known to have high mortality. We present the case of a 28-year-old obese female with type-II diabetes, hypertension, and pulmonary Koch admitted for moderate pulmonary impairment with hypoxia and altered metabolic dysfunctions in COVID-intensive care unit, facilitated to discharge with support of physiotherapy (PT). In spite of maximal standard medical management as per the COVID guidelines and oxygen support on nonrebreather bag at 15 L/min, she failed to show improvement in symptoms. PT interventions in the form of education and counseling, positioning, breathing exercises, and gradual peripheral conditioning were carried out to prevent complications and deterioration in view of associated comorbidities. This resulted in successful weaning-off oxygen, improved breath-holding time from 3s on PT day 3 to 11 s on PT day 15 and improved 6-min-walk distance from 165 m on PT day 7 to 215 m with no desaturation on PT day 15, reflecting improved respiratory and functional capacity. Timely intervention with respiratory PT and early out-of-bed mobility along with positive communication facilitated the path for discharge and independence in self-care.


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