Impact of SARS-CoV-2 pandemic in a phase II cardiac rehabilitation programme: looking back
Notice bibliographique
Résumé
Abstract Introduction SARS-CoV-2 has affected the whole world as a global health pandemic in 2020. A nationwide home confinement was declared in our country by beginning of March. Cardiac rehabilitation programs (CRP) had to adapt to new health requirements and the impact of these changes is unknown. Purpose To analyse the impact of COVID-19 pandemic in improvement of cardiopulmonary exercise test (CPET) with maximal oxygen consumption uptake (VO2max) and control of cardiovascular risk factors in patients with cardiovascular established disease (coronary heart disease, heart failure or cardiac surgery) included in the phase II of our centre CRP. Methods 510 consecutive patients were evaluated. A maximal CPET was performed for each patient from the beginning and at the end of phase II of CRP. Enrolled patients were divided in two groups: from March 2019 to March 2020 (before Covid pandemic) and second one, from the beginning of the pandemic in March 2020 until February 2021. Results 296 patients were studied in preCovid group and 214 patients were studied in Covid group. There were no statistically significant differences between these two groups in reference to cardiovascular risk factors and medical treatment (Figure 1). 82.7% of patients completed a hospital-based program in preCovid group vs 36% in Covid (p=0.001). Comparing the percentage of patients that accomplished the risk factors control targets between pre- and Covid group, statistically significant differences have been seen referring to systolic BP <140mmHg (85.1 vs 95.4%, p=0.001) and cLDL <70 mg/dl (67.2 vs 77.7%, p=0.003). However, in terms of glucose control (fasting blood glucose <110 mg/dl: 78.4 vs 82.2%, p=0.612; HbA1c <7%: 90.7 vs 92.7%, p=0.464) and weight control (BMI: 27.8±4.69 kg/m2 vs 27.3±4.07 kg/m2, p=0.299) this could not be established. There were no differences in psychological attention demand (27 vs 23.3%, p=0.695). Statistical differences between two groups were found in terms of VO2max at the beginning phase II CPET (22.7±7 vs 20±5 ml/min/kg, p=0.006) and ending phase II CPET (24±7 vs 21±6, p=0.001). Nevertheless, no differences were found in the final phase II CPET improvement between both groups (1.4±4.1 ml/kg/min vs 0.81±2.9 ml/kg/min; p=0.221) (Figure 2). Conclusions SARS-CoV-2 changed our practice from an in-hospital based phase II CRP to a home-based phase II CRP. COVID-19 pandemic had no negative impact in the control of risk factors in our phase II patients. In our experience, despite preCovid phase II patients have a better functional capacity in terms of VO2max, the improvement in VO2max after phase II CRP persists in the SARS-CoV-2 era. This might show that an accurate structure of home-based program could also have great results. Funding Acknowledgement Type of funding sources: None.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».