| Summary: | Worldwide, healthcare systems had to respond to an exponential increase in COVID-19 patients with a noteworthy increment in intensive care units (ICU) admissions and invasive mechanical ventilation (IMV). The aim was to determine low intensity respiratory muscle training (RMT) effects in COVID-19 patients upon medical discharge and after an ICU stay with IMV. A retrospective case-series study was performed. Forty COVID-19 patients were enrolled and divided into twenty participants who received IMV during ICU stay (IMV group) and 20 participants who did not receive IMV nor an ICU stay (non-IMV group). Maximal expiratory pressure (PE<sub>max</sub>), maximal inspiratory pressure (PI<sub>max</sub>), COPD assessment test (CAT) and Medical Research Council (MRC) dyspnea scale were collected at baseline and after 12 weeks of low intensity RMT. A greater MRC dyspnea score and lower PI<sub>max</sub> were shown at baseline in the IMV group versus the non-IMV group (<i>p</i> < 0.01). RMT effects on the total sample improved all outcome measurements (<i>p</i> < 0.05; <i>d</i> = 0.38–0.98). Intragroup comparisons after RMT improved PI<sub>max</sub>, CAT and MRC scores in the IMV group (<i>p</i> = 0.001; <i>d</i> = 0.94–1.09), but not for PI<sub>max</sub> in the non-IMV group (<i>p</i> > 0.05). Between-groups comparison after RMT only showed MRC dyspnea improvements (<i>p</i> = 0.020; <i>d</i> = 0.74) in the IMV group versus non-IMV group. Furthermore, PI<sub>max</sub> decrease was only predicted by the IMV presence (<i>R</i><sup>2</sup> = 0.378). Low intensity RMT may improve respiratory muscle strength, health related quality of life and dyspnea in COVID-19 patients. Especially, low intensity RMT could improve dyspnea level and maybe PI<sub>max</sub> in COVID-19 patients who received IMV in ICU.
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