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Delphi consensus recommendations on how to provide cardiovascular rehabilitation
in the COVID-19 era
#MMPMID33624042
Ambrosetti M
; Abreu A
; Cornelissen V
; Hansen D
; Iliou MC
; Kemps H
; Pedretti RFE
; Voller H
; Wilhelm M
; Piepoli MF
; Beccaluva CG
; Beckers P
; Berger T
; Davos CH
; Dendale P
; Doehner W
; Frederix I
; Gaita D
; Gevaert A
; Kouidi E
; Kraenkel N
; Laukkanen J
; Maranta F
; Mazza A
; Mendes M
; Neunhaeuserer D
; Niebauer J
; Pavy B
; Gil CP
; Rauch B
; Sarzi Braga S
; Simonenko M
; Cohen-Solal A
; Sommaruga M
; Venturini E
; Vigorito C
Eur J Prev Cardiol
2021[May]; 28
(5
): 541-557
PMID33624042
show ga
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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