Journal
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY
Volume 28, Issue 5, Pages 541-557Publisher
OXFORD UNIV PRESS
DOI: 10.1093/eurjpc/zwaa080
Keywords
Cardiovascular disease; Prevention; Rehabilitation; COVID-19; Coronavirus
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This Delphi consensus by 28 experts from the European Association of Preventive Cardiology provides initial recommendations on how cardiovascular rehabilitation facilities should modulate their activities during the ongoing COVID-19 pandemic. Consensus was reached on 58 statements, mainly focusing on referral, core components, and structure of CR activities suitable for managing cardiac COVID-19 patients. Experts suggested maintaining usual activities for traditional patient groups referred to CR during the pandemic, with minimal downgrading of intervention for COVID-19 patients as comorbidities.
This Delphi consensus by 28 experts from the European Association of Preventive Cardiology (EAPC) provides initial recommendations on how cardiovascular rehabilitation (CR) facilities should modulate their activities in view of the ongoing coronavirus disease 2019 (COVID-19) pandemic. A total number of 150 statements were selected and graded by Likert scale [from -5 (strongly disagree) to +5 (strongly agree)], starting from six open-ended questions on (i) referral criteria, (ii) optimal timing and setting, (iii) core components, (iv) structure-based metrics, (v) process-based metrics, and (vi) quality indicators. Consensus was reached on 58 (39%) statements, 48 'for' and 10 'against' respectively, mainly in the field of referral, core components, and structure of CR activities, in a comprehensive way suitable for managing cardiac COVID-19 patients. Panelists oriented consensus towards maintaining usual activities on traditional patient groups referred to CR, without significant downgrading of intervention in case of COVID-19 as a comorbidity. Moreover, it has been suggested to consider COVID-19 patients as a referral group to CR per se when the viral disease is complicated by acute cardiovascular (CV) events; in these patients, the potential development of COVID-related CV sequelae, as well as of pulmonary arterial hypertension, needs to be focused. This framework might be used to orient organization and operational of CR programmes during the COVID-19 crisis.
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