Cardiac rehabilitation activities during the COVID-19 pandemic in Italy. Position Paper of the AICPR (Italian Association of Clinical Cardiology, Prevention and Rehabilitation).

The COVID-19 outbreak is having a significant impact on both cardiac rehabilitation (CR) inpatient and outpatient healthcare organization. The variety of clinical and care scenarios we are observing in Italy depends on the region, the organization of local services and the hospital involved. Some hospital wards have been closed to make room to dedicated beds or to quarantine the exposed health personnel. In other cases, CR units have been converted or transformed into COVID-19 units.  The present document aims at defining the state of the art of CR during COVID-19 pandemic, through the description of the clinical and management scenarios frequently observed during this period and the exploration of the future frontiers in the management of cardiac rehabilitation programs after the COVID-19 outbreak.

[1]  S. Maffoni,et al.  Position paper of the Italian association of medical specialists in dietetics and clinical nutrition (ANSISA) on nutritional management of patients with COVID-19 disease , 2020, Mediterranean Journal of Nutrition and Metabolism.

[2]  Catherine Klersy,et al.  Out-of-Hospital Cardiac Arrest during the Covid-19 Outbreak in Italy , 2020, The New England journal of medicine.

[3]  J. Connors,et al.  COVID-19 and its implications for thrombosis and anticoagulation , 2020, Blood.

[4]  André Machado Siqueira,et al.  Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Clinical Trial. , 2020, JAMA network open.

[5]  Sung‐Han Kim,et al.  Interim Guidelines on Antiviral Therapy for COVID-19 , 2020, Infection & chemotherapy.

[6]  G. Serafini,et al.  Aged Patients With Mental Disorders in the COVID-19 Era: The Experience of Northern Italy , 2020, The American Journal of Geriatric Psychiatry.

[7]  Yaolong Chen,et al.  Prevention and Treatment of Venous Thromboembolism Associated with Coronavirus Disease 2019 Infection: A Consensus Statement before Guidelines , 2020, Thrombosis and Haemostasis.

[8]  Sunil V. Rao,et al.  Management of Acute Myocardial Infarction During the COVID-19 Pandemic , 2020, Journal of the American College of Cardiology.

[9]  J. Rogers,et al.  Virtual Visits for Care of Patients with Heart Failure in the Era of COVID-19: A Statement from the Heart Failure Society of America , 2020, Journal of Cardiac Failure.

[10]  G. Gerosa,et al.  The COVID-19 outbreak and its impact on hospitals in Italy: the model of cardiac surgery , 2020, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[11]  Yutao Guo,et al.  COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-Up , 2020, Journal of the American College of Cardiology.

[12]  D. Roden,et al.  Considerations for Drug Interactions on QTc in Exploratory COVID-19 (Coronavirus Disease 2019) Treatment , 2020, Heart Rhythm.

[13]  B. Pfefferbaum,et al.  Mental Health and the Covid-19 Pandemic. , 2020, The New England journal of medicine.

[14]  D. Gommers,et al.  Incidence of thrombotic complications in critically ill ICU patients with COVID-19 , 2020, Thrombosis Research.

[15]  D. Roden,et al.  Considerations for Drug Interactions on QTc in Exploratory COVID-19 (Coronavirus Disease 2019) Treatment. , 2020, Circulation.

[16]  D. Juurlink.  Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection , 2020, Canadian Medical Association Journal.

[17]  J. Healey,et al.  Guidance on Minimizing Risk of Drug-Induced Ventricular Arrhythmia During Treatment of COVID-19: A Statement from the Canadian Heart Rhythm Society , 2020, Canadian Journal of Cardiology.

[18]  Junwei Liu,et al.  End-Stage Heart Failure With COVID-19 , 2020, JACC: Heart Failure.

[19]  M. Yousefifard,et al.  Antiviral therapy in management of COVID-19: a systematic review on current evidence , 2020, Archives of academic emergency medicine.

[20]  G. Pontone,et al.  COVID-19 pandemic and cardiac imaging: EACVI recommendations on precautions, indications, prioritization, and protection for patients and healthcare personnel , 2020, European heart journal cardiovascular Imaging.

[21]  G. de Simone,et al.  Speculation is not evidence: antihypertensive therapy and COVID-19 , 2020, European heart journal. Cardiovascular pharmacotherapy.

[22]  Li Yan,et al.  Implications for Online Management: Two Cases with COVID-19. , 2020, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[23]  M. Salminen,et al.  Understanding coronavirus disease (COVID-19) risk perceptions among the public to enhance risk communication efforts: a practical approach for outbreaks, Finland, February 2020 , 2020, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[24]  Stephan C. Bischoff,et al.  ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection , 2020, Clinical Nutrition.

[25]  P. Ish,et al.  Chloroquine in COVID-19: the evidence. , 2020, Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace.

[26]  Dominique Hansen,et al.  Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology. , 2020, European journal of preventive cardiology.

[27]  A. Goel,et al.  Emerging prophylaxis strategies against COVID-19. , 2020, Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace.

[28]  Mohammad Madjid,et al.  Potential Effects of Coronaviruses on the Cardiovascular System: A Review. , 2020, JAMA cardiology.

[29]  Simone Cecchetto,et al.  Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a Position Paper of the Italian Association of Respiratory Physiotherapists (ARIR). , 2020, Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace.

[30]  T. Greenhalgh,et al.  Covid-19: a remote assessment in primary care , 2020, BMJ.

[31]  W. Gong,et al.  Association of Cardiac Injury With Mortality in Hospitalized Patients With COVID-19 in Wuhan, China. , 2020, JAMA cardiology.

[32]  A. Akbari,et al.  Prevalence of Underlying Diseases in Hospitalized Patients with COVID-19: a Systematic Review and Meta-Analysis , 2020, Archives of academic emergency medicine.

[33]  Sharukh Lokhandwala,et al.  Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State. , 2020, JAMA.

[34]  Rui-guang Zhang,et al.  Clinical Features of 69 Cases with Coronavirus Disease 2019 in Wuhan, China , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[35]  Xin Zhou,et al.  Risk Factors Associated With Acute Respiratory Distress Syndrome and Death in Patients With Coronavirus Disease 2019 Pneumonia in Wuhan, China , 2020, The Journal of Emergency Medicine.

[36]  David S Jones.  History in a Crisis - Lessons for Covid-19. , 2020, The New England journal of medicine.

[37]  Michael Roth,et al.  Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? , 2020, The Lancet Respiratory Medicine.

[38]  Liwei Zhang,et al.  Effective Risk Communication for Public Health Emergency: Reflection on the COVID-19 (2019-nCoV) Outbreak in Wuhan, China , 2020, Healthcare.

[39]  J. Xiang,et al.  Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study , 2020, The Lancet.

[40]  Ivan Griffin,et al.  COVID-19: combining antiviral and anti-inflammatory treatments , 2020, The Lancet Infectious Diseases.

[41]  G. Rubin,et al.  The psychological impact of quarantine and how to reduce it: rapid review of the evidence , 2020, The Lancet.

[42]  R. Rizzoli,et al.  Nutritional strategies for maintaining muscle mass and strength from middle age to later life: A narrative review. , 2020, Maturitas.

[43]  S. Scalvini,et al.  How can multidisciplinary management with remote monitoring improve the outcome of patients with chronic cardiac diseases? , 2020, Expert review of medical devices.

[44]  L. De Luca,et al.  High thrombotic risk increases adverse clinical events up to 5 years after acute myocardial infarction. A nationwide retrospective cohort study. , 2019, Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace.

[45]  S. Köpke,et al.  Patients’ Experiences of Cardiovascular Health Education and Risk Communication: A Qualitative Synthesis , 2019, Qualitative health research.

[46]  Goran Krstačić,et al.  ESC e-Cardiology Working Group Position Paper: Overcoming challenges in digital health implementation in cardiovascular medicine , 2019, European journal of preventive cardiology.

[47]  Richard W. Bohannon,et al.  1-Minute Sit-to-Stand Test: SYSTEMATIC REVIEW OF PROCEDURES, PERFORMANCE, AND CLINIMETRIC PROPERTIES , 2019, Journal of cardiopulmonary rehabilitation and prevention.

[48]  S. Scalvini,et al.  Cardiac Prevention and Rehabilitation "3.0": From acute to chronic phase. Position Paper of the ltalian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR). , 2018, Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace.

[49]  M. Piepoli,et al.  What constitutes the ‘Minimal Care’ interventions of the nurse, physiotherapist, dietician and psychologist in Cardiovascular Rehabilitation and secondary prevention: A position paper from the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology , 2018, European journal of preventive cardiology.

[50]  Y. Li,et al.  Altered Lipid Metabolism in Recovered SARS Patients Twelve Years after Infection , 2017, Scientific Reports.

[51]  Simonetta Scalvini,et al.  Maugeri Centre for Telehealth and Telecare: A real-life integrated experience in chronic patients , 2017, Journal of telemedicine and telecare.

[52]  T. Ivanova,et al.  2016 European Guidelines on cardiovascular disease prevention in clinical practice , 2016 .

[53]  M. Vitacca,et al.  Development of a Barthel Index based on dyspnea for patients with respiratory diseases , 2016, International journal of chronic obstructive pulmonary disease.

[54]  Karin Coninx,et al.  Effect of comprehensive cardiac telerehabilitation on one-year cardiovascular rehospitalization rate, medical costs and quality of life: A cost-effectiveness analysis , 2016, European journal of preventive cardiology.

[55]  O. Bienvenu,et al.  Posttraumatic stress disorder (PTSD) after critical illness: A conceptual review of distinct clinical issues and their implications. , 2016, Rehabilitation psychology.

[56]  Thierry Troosters,et al.  An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease , 2014, European Respiratory Journal.

[57]  Jane L. Canavan,et al.  Phenotypic characteristics associated with reduced short physical performance battery score in COPD. , 2014, Chest.

[58]  G. Oudit,et al.  Role of angiotensin-converting enzyme 2 (ACE2) in diabetic cardiovascular complications. , 2014, Clinical science.

[59]  M. Piepoli,et al.  [Standards and outcome measures in cardiovascular rehabilitation. Position paper GICR/IACPR]. , 2012, Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace.

[60]  C. Opasich,et al.  An elderly-centered, personalized, physiotherapy program early after cardiac surgery , 2010, European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology.

[61]  G. Boysen,et al.  European Guidelines on Cardiovascular Disease Prevention , 2009, International journal of stroke : official journal of the International Stroke Society.

[62]  Shah Ebrahim,et al.  Fourth Joint Task Force of the European Society of Cardiology and other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) , 2007 .

[63]  R W Bohannon,et al.  Normative values for isometric muscle force measurements obtained with hand-held dynamometers. , 1996, Physical therapy.

[64]  Accessed from , 2012 .

[65]  Brent K. Bailey,et al.  Prepared by the , 1989 .

[66]  Ack,et al.  LOWER-EXTREMITY FUNCTION IN PERSONS OVER THE AGE OF 70 YEARS AS A PREDICTOR OF SUBSEQUENT DISABILITY , 2001 .