BACKGROUND: Severe acute respiratory syndrome coronavirus 2 is a new strain of coronavirus that started in 2019 and causes a pandemic disease called coronavirus disease 2019 (COVID-19). The present report result was 80% of cases are asymptomatic or mild; 15% of cases are severe; and 5% are critical needing ICU and mechanical ventilation. Physiotherapy (PT) provides airway clearance techniques and improves physical fitness. AIM: The aim of this study is to assess the effect of PT and the frequency of PT session on the outcome of patients with COVID-19 infection at an isolation unit of Ain Shams University. PATIENTS AND METHODS: This is randomized controlled clinical trial that was applied on 264 confirmed adult patients with COVID-19, who were admitted to isolation units at Ain Shams University Hospitals over 6 months since March 2021 with 134 females and 130 males in the age range from 31 to 82 years. The breathing method was room air, oxygen mask and nasal cannula, HFNC, and ventilated patients (both invasive and noninvasive). The patients were divided randomly into two groups: one group received two sessions of PT per day and the other group received one session of PT per day. RESULTS: The patients were divided clinically into mild, moderate, severe, and severe-critical patients. In mild cases, the range of incentive spirometer (ml) after one daily PT became 2300 to 2800 ml, and for twice daily PT it became 2300 to 3300 ml with highly statistical difference (p = 0.005) before and after one or two PT sessions. Regarding 6-min walking test (m) the range became 420 to 740 m for one PT session per day and 420 to 880 m for two PT sessions per day with significant statistical difference (p = 0.010). In moderate cases, the SPO 2 (%) became 88 to 98% after one daily PT session and 90 to 98% after twice daily PT sessions with significant statistical differences between the one and two PT (p = 0.032) sessions. Regarding the incentive spirometer (ml) at the moderate group, after one daily PT session it became 1200 to 2500 ml and for twice daily PT it became 1500 to 2500 ml with significant statistical differences between one and two PT sessions (p = 0.032). CONCLUSION: Patients with mild and moderate COVID-19 infection had significant improvement in SPO 2 (oxygen saturation), dyspnea scale, and incentive spirometer after receiving two daily sessions of PT compared with patients who received one daily PT session. There was no difference in both groups for severe and severe-critical cases.

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