Cardiac Rehabilitation in Post COVID-19 Patients with Cardiovascular Diseases Complipication: Review Article

Main Article Content

Dian Marta Sari
Astari Khairunnisa
Laurentia Cindy Gani Wijaya
Patricia Helena Christiani Santoso
Hawani S Prameswari
Mohammad Iqbal
Sunaryo Bardi Sastradimaja

Abstract

Abstract


Introduction: The outbreak of COVID-19 has been linked to an increased risk to heart health, emphasizing the significance of Cardiac Rehabilitation (CR) in tackling these concerns. This review is intended to improve comprehension of the effects of COVID-19 on cardiovascular health and to assist healthcare providers in their care of patients.


Methods:This study employs a comprehensive literature review covering 2019 to 2021, using keywords "Sars-Cov-2" OR "COVID-19" AND "Cardiovascular Diseases" AND "Cardiac Rehabilitation" across various databases. After screening, 321 articles yielded 32 studies for the pooled analysis. 


Results: During the outbreak, 14.4% of the individuals developed acute cardiovascular issues, with a mortality rate ranging from 5.6% to 10.5%, surpassing the seasonal flu mortality rates. Patients post-COVID-19 exhibit similar clinical manifestations, necessitating rehabilitation to enhance their quality of life and prevent future complications. Amidst the pandemic, cardiac rehabilitation centers have shifted to virtual or telemedicine rehabilitation owing to interruptions in regular services.


Discussion: COVID-19 commonly triggers myocarditis, heart failure (HF), arrhythmias, and venous thromboembolism (VTE). Pre-hospital diagnostics and post-discharge follow-up via telemedicine rehabilitation present effective strategies for managing patients with cardiovascular disease (CVD), offering additional clinical insights for cardiologists to diagnose and differentially diagnose patients without in-person consultations.


Conclusion: COVID-19 survivors face potential CVD complications, underscoring the need for CR to improve the quality of life and mitigate CVD risks post-exposure. This rehabilitation approach holds promise for reducing mortality among patients with post-COVID-19 heart disease.


 

Article Details

Section

Literature Review

Author Biographies

Dian Marta Sari, Universitas Padjadjaran

Cardiorespiratory Division, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia

Astari Khairunnisa, Universitas Padjadjaran

Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia

Laurentia Cindy Gani Wijaya, Siloam Hospitals Kebon Jeruk

General Practitioner, Siloam Hospitals Kebon Jeruk, Jakarta, Indonesia

Patricia Helena Christiani Santoso, Regional Public Hospital Cikalong Wetan

General Practitioner, Regional Public Hospital Cikalong Wetan, Bandung, Indonesia

Hawani S Prameswari, Universitas Padjadjaran

Clinical Cardiology Heart Failure Division, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia

Mohammad Iqbal, Universitas Padjadjaran

Electrophysiology and Arrhythmia Division, Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia

Sunaryo Bardi Sastradimaja, Universitas Padjadjaran

Cardiorespiratory Division, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia

How to Cite

Cardiac Rehabilitation in Post COVID-19 Patients with Cardiovascular Diseases Complipication: Review Article. (2024). Indonesian Journal of Physical Medicine and Rehabilitation, 13(01), 57-73. https://doi.org/10.36803/indojpmr.v13i01.409

References

Veska D. Frequently asked questions about coronavirus disease (covid-19). Novel Coronavirus (COVID-19): What you should know - UNICEF Indonesia. https://www.unicef.org/indonesia/coronavirus/FAQ. Accessed 5th Oct 2021

European Society of Cardiology. Guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 1-epidemiology, pathophysiology, and diagnosis. Eur Heart J. 2022; 43:1033–1058. Doi:10.1093/eurheartj/ehab696 DOI: https://doi.org/10.1093/eurheartj/ehab866

Clerkin KJ, Fried JA, Raikhelkar J, et al. COVID-19 and Cardiovascular Disease. J Circulation. 2020;141(20):1648–1655. doi: 10.1161/CIRCULATIONAHA.120.046941. DOI: https://doi.org/10.1161/CIRCULATIONAHA.120.046941

MariÄić L, Mihić D, SuÅ¡ić L, Loinjak D. COVID-19 Cardiac Complication- Myocarditis. J Open COVID. 2021; 1:1–5. doi:10.2174/2666958702101010001 DOI: https://doi.org/10.2174/2666958702101010001

Taylor RS, Dalal HM, McDonagh STJ.The role of cardiac rehabilitation in improving cardiovascular outcomes. Nature Reviews Cardiology. 2022; 19:180–194 DOI: https://doi.org/10.1038/s41569-021-00611-7

Van Iterson EH, Laffin LJ, Crawford M, et al. Cardiac Rehabilitation Is Essential in the COVID-19 Era: Delivering Uninterrupted Heart Care Based On The Cleveland Clinic Experience. J Cardiopulmonary Rehabilitation and Prev. 2021; 41:88–92. doi:10.1097/HCR.0000000000000585 DOI: https://doi.org/10.1097/HCR.0000000000000585

Lim SL, Woo KL, Lim E, et al. Impact of COVID-19 on health-related quality of life in patients with cardiovascular disease: a multi-ethnic Asian study. J Health and Quality of Life Outcomes. 2020; 18:1–7. doi:10.1186/s12955-020-01640-5 DOI: https://doi.org/10.1186/s12955-020-01640-5

Ambrosetti M, Abreu A, Cornelissen V, et al. Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era. J Eur Prev Cardiol. 2021; 28:541–557. doi:10.1093/eurjpc/zwaa080 DOI: https://doi.org/10.1093/eurjpc/zwaa080

Pavli A, Theodoridou M, Maltezou HC. Post-COVID Syndrome: Incidence, Clinical Spectrum, and Challenges for Primary Healthcare Professionals. Arch Med Research. 2021; 52:575–581. doi:10.1016/j.arcmed.2021.03.010 DOI: https://doi.org/10.1016/j.arcmed.2021.03.010

Nalbandian A, Sehgal K, Gupta A, et al. Post-acute COVID-19 syndrome. J Nature Med. 2021; 27(4):601–615. doi: 10.1038/s41591-021-01283-z DOI: https://doi.org/10.1038/s41591-021-01283-z

CDC. Post-COVID Conditions. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html. Accessed 25th Dec 2021

Sarfraz Z, Sarfraz A, Barrios A, et al. Cardio-Pulmonary Sequelae in Recovered COVID-19 Patients: Considerations for Primary Care. J Primary Care and Community Health. 2021; 12. doi:10.1177/21501327211023726 DOI: https://doi.org/10.1177/21501327211023726

Jaiswal V, Sarfraz Z, Sarfraz A, et al. COVID-19 Infection and Myocarditis: A State-of-the-Art Systematic Review. J Primary Care and Community Health. 2021; 12. doi:10.1177/21501327211056800 DOI: https://doi.org/10.1177/21501327211056800

Nicholls SJ, Nelson M, Astley C, et al. Optimising Secondary Prevention and Cardiac Rehabilitation for Atherosclerotic Cardiovascular Disease During the COVID-19 Pandemic: A Position Statement From the Cardiac Society of Australia and New Zealand (CSANZ). J Heart Lung and Circulation. 2020; 29(7):99–104. doi: 10.1016/j.hlc.2020.04.007 DOI: https://doi.org/10.1016/j.hlc.2020.04.007

Besnier F, Gayda M, Nigam A, et al. Cardiac Rehabilitation During Quarantine in COVID-19 Pandemic: Challenges for Center-Based Programs. Arch Phys Med and Rehabilitation. 2020; 101(10):1835–1838. doi: 10.1016/j.apmr.2020.06.004 DOI: https://doi.org/10.1016/j.apmr.2020.06.004

Fersia O, Bryant S, Nicholson R, et al. The impact of the COVID-19 pandemic on cardiology services. J Open Heart. 2020; 7. doi:10.1136/openhrt-2020-001359 DOI: https://doi.org/10.1101/2020.06.10.20126458

Mureddu GF, Ambrosetti M, Venturini E, et al. Cardiac rehabilitation activities during the COVID-19 pandemic in Italy. Position paper of the AICPR (Italian Association of Clinical Cardiology, Prevention and Rehabilitation). Monaldi Arch for Chest Disease. 2020; 90:353–366. doi:10.4081/MONALDI.2020.1439 DOI: https://doi.org/10.4081/monaldi.2020.1439

Percy E, Luc JGY, Vervoort D, et al. Post-Discharge Cardiac Care in the Era of Coronavirus 2019: How Should We Prepare? Canadian J Cardiology. 2020; 36:956–960. doi:10.1016/j.cjca.2020.04.006 DOI: https://doi.org/10.1016/j.cjca.2020.04.006

Bader F, Manla Y, Atallah B, Starling RC. Heart failure and COVID-19. Heart Failure Rev. 2021; 26(1):1-10. doi: 10.1007/s10741-020-10008-2 DOI: https://doi.org/10.1007/s10741-020-10008-2

Swarnakar R, Resident J, Dev K, et al ReCOVer study: A Cross-sectional Observational Study to Identify the Rehabilitation Need in Post-discharge COVID-19 Survivors Authors. doi:10.1101/2021.04.19.21255750 DOI: https://doi.org/10.1101/2021.04.19.21255750

Wong C, Mansoor A, Mcginn T. A Cross-sectional Study of Clinical COVID-19 Myocarditis: Differences in Biomarkers in Fulminant and Non-fulminant Cases. 2021. doi:10.1101/2021.06.06.21258423 DOI: https://doi.org/10.1101/2021.06.06.21258423

O’gallagher K, Shek A, Bean DM, et al. Pre-existing cardiovascular disease rather than cardiovascular risk factors drives mortality in COVID-19. BMC Cardiovasc Disord. 2021; 21(327). doi:10.1101/2020.12.02.20242933 DOI: https://doi.org/10.1186/s12872-021-02137-9

Sardinha DM, Lima KV, Ueno TM, et al. Occurrence of cardiovascular complications associated with SARS-CoV-2 infection: a systematic review. J Pharmaceutical Research Int. 2020. doi:10.1101/2020.11.14.20231803 DOI: https://doi.org/10.9734/jpri/2021/v33i1431270

Hamam O, Goda A, Eldalal M, et al. Cardiac Arrhythmias in Patients with COVID-19: A Systematic review and Meta-analysis. 2020. doi:10.1101/2020.10.09.20209379 DOI: https://doi.org/10.1101/2020.10.09.20209379

al Tamimi H, Alhamad Y, Khazaal F, et al. The Outcome of COVID-19 Patients with Acute Myocardial Infarction. 2020. doi:10.1101/2020.07.21.20156349 DOI: https://doi.org/10.1101/2020.07.21.20156349

Caraballo C, McCullough M, Fuery MA, et al. COVID-19 infections and outcomes in a live registry of heart Failure patients across an integrated health care system. 2020. doi:10.1101/2020.04.27.20082016 DOI: https://doi.org/10.1101/2020.04.27.20082016

Lala A, Johnson KW, Januzzi JL, et al. Prevalence and Impact of Myocardial Injury in Patients Hospitalized With COVID-19 Infection. J Am Coll Cardiol. 2020; 76:533–546. doi:10.1016/j.jacc.2020.06.007 DOI: https://doi.org/10.1016/j.jacc.2020.06.007

Henrina J, Santosa Putra IC, Cahyadi I, et al. Clinical characteristics and outcomes of Venous Thromboembolism in patients hospitalized for COVID-19: Systematic review and meta-analysis. Thrombosis Update. 2020. doi:10.1101/2020.06.14.20130922 DOI: https://doi.org/10.1101/2020.06.14.20130922

Thakkar S, Arora S, Kumar A, et al. A systematic review of the cardiovascular manifestations and outcomes in the setting of coronavirus-19 disease. 2020. doi:10.1101/2020.08.09.20171330 DOI: https://doi.org/10.1177/1179546820977196

Aiyegbusi OL, Hughes SE, Turner G, et al. Symptoms, complications and management of long COVID: a review. J R Soc Med. 2021; 114:428–442 DOI: https://doi.org/10.1177/01410768211032850

Batalik L, Konecny V, Dosbaba F, et al. Cardiac rehabilitation based on the walking test and telerehabilitation improved cardiorespiratory fitness in people diagnosed with coronary heart disease during the covid-19 pandemic. J Environmental Research and Public Health. 2021; 18:1–11. doi:10.3390/ijerph18052241 DOI: https://doi.org/10.3390/ijerph18052241

Ma L, Xiong X, Yan L, et al. Home-based exercise is associated with improved cardiac functional performance in patients after acute myocardial infarction. J Int Med Research. 2020; 48. doi:10.1177/0300060520977637 DOI: https://doi.org/10.1177/0300060520977637

Thamman R, Janardhanan R. Cardiac rehabilitation using telemedicine: the need for tele cardiac rehabilitation. J Cardiovascular Med. 2020; 21:497–500. doi:10.31083/j.rcm.2020.04.201 DOI: https://doi.org/10.31083/j.rcm.2020.04.201

Cavalheiro AH, Silva Cardoso J, Rocha A, et al. Effectiveness of Telerehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis. J Health Services Insights. 2021; 14. doi: 10.1177/11786329211021668 DOI: https://doi.org/10.1177/11786329211021668

Scherrenberg M, Wilhelm M, Hansen D, et al. The future is now: A call for action for cardiac telerehabilitation in the COVID-19 pandemic from the secondary prevention and rehabilitation section of the European Association of Preventive Cardiology. J European of Preventive Cardiology. 2021; 28:524–540. doi:10.1177/2047487320939671 DOI: https://doi.org/10.1177/2047487320939671

Kato M, Ono S, Seko H, et al. Trajectories of frailty, physical function, and physical activity levels in elderly patients with heart failure: Impacts of interruption and resumption of outpatient cardiac rehabilitation due to COVID-19. J International of Rehabilitation Research. 2021 doi:10.1097/MRR.0000000000000473 DOI: https://doi.org/10.1097/MRR.0000000000000473

Moulson N, Bewick D, Selway T, et al. Cardiac Rehabilitation During the COVID-19 Era: Guidance on Implementing Virtual Care. J Canadian of Cardiology. 2020; 36:1317–1321. doi:10.1016/j.cjca.2020.06.006 DOI: https://doi.org/10.1016/j.cjca.2020.06.006

Nan J, Jia R, Meng S, et al. The Impact of the COVID-19 Pandemic and the Importance of Telemedicine in Managing Acute ST Segment Elevation Myocardial Infarction Patients: Preliminary Experience and Literature Review. J Med Syst. 2021; 45(9). doi:10.1007/s10916-020-01703-6/Published DOI: https://doi.org/10.1007/s10916-020-01703-6

Beleigoli A, Champion S, Tirimacco R, et al. A co-designed telehealth-based model of care to improve attendance and completion to cardiac rehabilitation of rural and remote Australians: The Country Heart Attack Prevention (CHAP) project. J Telemedicine and Telecare. 2021; 27:685–690. doi:10.1177/1357633X211048400 DOI: https://doi.org/10.1177/1357633X211048400

Scott-Sheldon LAJ, Gathright EC, Wu W-C. Promoting Social Connectedness among Cardiac Rehabilitation Patients During the COVID-19 Pandemic and Beyond. R I Med J. 2013; 103(9):34-35

Scherrenberg M, Falter M, Dendale P. Patient experiences and willingness-to-pay for cardiac telerehabilitation during the first surge of the COVID-19 pandemic: single-centre experience. Acta Cardiol. 2021; 76(2):151–157. doi:10.1080/00015385.2020.1846920 DOI: https://doi.org/10.1080/00015385.2020.1846920

de Melo Ghisi GL, Xu Z, Liu X, et al. Impacts of the COVID-19 Pandemic on Cardiac Rehabilitation Delivery around the World. Glob Heart J. 2020; 16(1):43. doi:10.5334/gh.939 DOI: https://doi.org/10.5334/gh.939

Jaiswal V, Nagpal S, Labitag CAE, et al. A Systematic Review of COVID-19 Induced Myocarditis-Symptomatology, Prognosis, and Clinical Findings. 2021 doi:10.1101/2021.05.29.21258059 DOI: https://doi.org/10.1101/2021.05.29.21258059

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