Physiotherapy as a Complimentary Treatment in Reducing Viral-Load, Complications, Death, Expedite Discharge and Improve Quality of Life, Exercise Endurance and Capacity in Stroke Survivors With CoViD-19: A Clinical-Controlled Study

Introduction Coronavirus disease 2019 (CoViD-19) is a new pathogen that is highly contagious, can spread quickly, and it is capable of causing enormous health, economic and societal impacts in any setting (WHO-China joint mission on CoViD-19). Although COVID 19 belongs to coronavirinae sub-family and coronaviridae family and different from other previous coronaviruses such as SARS-CoV and influenza Virus with its unique characteristics. Hence, building scenarios and strategies only on the basis of well-known pathogens risks failing to exploit all possible measures to slow transmission of the COVID-19 virus, reduce disease and save lives.

The COVID-19 virus is unique among human coronaviruses in its combination of high transmissibility, substantial fatal outcomes in some high-risk groups, and ability to cause huge societal and economic disruption. The current CoViD-19 pandemic arises from Severe Acute Respiratory Syndrome Voronavirus 2 (SARS CoV-2) which was first detected as pneumonia of unknown cause in Wuhan, China in December, 2019. It was declared as public health emergency of international concern in January, 2020 and global pandemic in February of the same year. Therefore, with the novel nature, and the continuously evolving understanding, of this coronavirus demands a tremendous agility in the capacity to rapidly adapt and change readiness and response planning both for containment and for treatment of the disease and its emerging sequels.

Before the advent of CoViD-19, different types of coronavirus known in human history include the alpha coronaviruses HCoV-229E and HCoV-NL63; the beta coronaviruses HCoV-OC43 and HCoV-HKU1; SARS-CoV, which causes severe acute respiratory syndrome (SARS); MERS-CoV, which causes Middle East respiratory syndrome (MERS). The definitive diagnosis of CoViD-19 is made by analysing respiratory samples (collected by aspiration of the airways or sputum induction) through laboratory tests to identify the virus involved using Real-Time Polymerase Chain Reaction (RT-PCR) techniques.

Although the American and Europe are mostly affected with Africa being the least affected, almost all the African countries have had their fair share of the pandemic both in incidence and in fatality. Although the first fatality was recorded in China, the fatality is now global. There is no gender variation in the global epidemiology of CoViD-19 but the males are experiencing higher fatality rate when controlled for age and the presence of comorbid health problem. However, in Nigeria, the mortality rate is 3.1% with male preponderance (2.2:1 male to female ratio) and affects more people between 31 years and 40 years.

Between 2 days to 14 days post-exposure, individuals with CoViD-19 can have symptoms ranging from mild to severe including but not limited to fever, cough, difficulty in breathing/shortness of breath, sore throat, muscle pain, chills, new loss of taste or smell, nausea, vomiting and diarrhea. Although the disease is fast spreading across the globe, yet there is no known standard cure for it neither is vaccine available against the new virus. However, as the disease manifest its clinical features, various case management/treatment guidelines are being developed and updated periodically by all national and international health organisations and the WHO.