## 4 Discussion  
To the best of our knowledge, this is one of the few studies in the scientific literature that investigates the impact of different types of physiotherapeutic intervention on the symptoms and the effort capacity of COVID-19 patients. The study results suggest that for the patients included in the present study, the combination of active physiotherapy with pharmacological treatment significantly reduce symptoms like dry cough, as well as dyspnea. Depending on the type of physiotherapy, a significant improvement in symptoms was observed. Our data are in concordance with literature data, which emphasize the real effectiveness of physiotherapy in respiratory patients admitted to the ICU for reducing their oxygen need [37]. This study has several limitations, one of which is represented by the small number of participants. Also, we studied only the acute effects of the interventions, and thus, long-term effects could not be evaluated. The global assessment of the lung function during this study was not possible because this type of investigation was not allowed to be conducted on patients infected with SARS-CoV-2 [6]. A limitation of this study is the impact on the quality of life (QOL) of patients with COVID-19, regardless of the time of discharge after hospitalization and recovery. Healthcare providers need to focus on assessing patients' needs and implementing effective strategies to quantify the quality of life of post-COVID-19 patients who have or have not had PT. [PERSON] et al., in 2022, published a study on the evaluation of QOL in post-COVID-19 patients, which shows that QOL has been severely affected, regardless of the time elapsed since discharge or recovery. They show that older patients with various disabilities, along with women, have experienced a considerable decrease in quality of life [38]. More studies are needed to investigate not only the impact that physiotherapy has on the clinical manifestation of the disease but also on effort capacity, muscle strength, and lung capacity. We consider that the implementation of physiotherapy in the treatment of this category of patients can be considered an interesting therapeutic tool, which can be implemented after a thorough assessment of the abilities, needs, and comorbidities of each patient. Especially in countries with a high prevalence of SARS-CoV-2 and a subsequent number of patients with temporary pulmonary disability, physiotherapy may represent a cost-efficient option, able to diminish respiratory symptoms, preserve or improve lung function, and reduce both short- and long-term complications. Breathing exercises, along with other types of physiotherapies, conducted in the acute phase of this disease, can represent a promising therapeutic strategy for improving the physical competence of these patients and addressing the most disturbing COVID-19 symptoms (such as dry cough and dyspnea). Also, the findings of the present study could be exploited by researchers and clinicians, in order to better understand and address the impairments and rehabilitation needs of COVID-19 patients. Study design, I.O., D.M., R.G., O.P.-V., and I.B. ; data collection, I.O., R.G., and D.M. ; data analysis, G.D.M., M.-E.D., O.-D.H.-E., O.P.-V., D.E.C., and I.B. ; drafting manuscript, I.O., M.-E.D., O.P.-V., D.-A.I., A.-G.D., I.L.S., and A.-I.G. All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas, and took part in drafting, revising, or critically reviewing the article. All authors have read and agreed to the published version of the manuscript. **Funding:** The present manuscript's article publishing charges were paid by \"Dunarea de Jos\" University of Galati. **Institutional Review Board Statement:** The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Institutional Review Board (Ethics Committee of Micromedica) no. 263/11 May 2020.