Impact of COVID-19?s on Cardiovascular Rehabilitation Programs in Brazil: An Online Survey-Based Cross- Sectional Study

Background: The COVID-19 pandemic had an impact on cardiovascular rehabilitation (CR) programs in Brazil.Objectives: To describe the characteristics of CR programs in Brazil, the impacts of the first epidemiological wave of COVID-19 (first 60 days) on the programs and present the initiatives used to overcome the impacts.Methods: This cross-sectional and retrospective study utilized a specific online survey. Participants were coordinators of CR programs. Variables were presented by Brazilian geographic region and as the following categories: demographic, clinical and operational characteristics. The significance level for statistical analysis was set at 5%.Results: Fifty-nine CR programs were responsible for 5,349 patients, of which only 1,817 were post-acute cardiovascular events, which corresponded to 1.99% of hospitalized patients in the month prior to the survey (n=91,231). The greatest impact was the suspension of on-site activities, which occurred similarly in areas with the highest and the lowest rates of COVID-19 in the period. Forty-five programs (75%) were shortly interrupted, while three (5%) were ended. All 42 programs that already used remote rehabilitation strategies noticed a substantial increase in activities, based primarily on the use of media and video calling. Only three (5%) considered safe to see patients during the first 60 days.Conclusions: There was a reduction in the number of CR programs with the COVID-19 pandemic. Telerehabilitation activities increased during the first two months of the COVID-19 pandemic, but this was not enough to overcome the reduction in CR program activities across Brazil.

Automated summary

This study describes the characteristics of cardiovascular rehabilitation (CR) programs in Brazil, and the impact of the first wave of COVID-19 on these programs. The results show that the pandemic led to the suspension or termination of CR programs, but there was an increase in activities using remote rehabilitation strategies.