key: cord-0847866-cvwhurmc authors: Besnier, Florent; Gayda, Mathieu; Nigam, Anil; Juneau, Martin; Bherer, Louis title: Cardiac Rehabilitation during quarantine in COVID-19 Pandemic: Challenges for Center based programs date: 2020-06-27 journal: Arch Phys Med Rehabil DOI: 10.1016/j.apmr.2020.06.004 sha: acfcc53e6de0c14bdcb60515a49068e873ae6478 doc_id: 847866 cord_uid: cvwhurmc Abstract Due to the COVID-19 epidemic, many cardiac rehabilitation (CR) services and programs are stopped. Because CR is a Class I level A recommendation with clinical benefits that are now well documented, the cessation of CR programs can lead to dramatic consequences in terms of public health. We proposed here a viewpoint of significant interest about the sudden need to develop remote home-based CR programs both in clinical research and in clinical care routine. This last decade, the literature on remote home-based cardiac rehabilitation programs has been increasing but to date only clinical research experiences have been implemented. Benefits are numerous and the relevance of this approach has obviously increased with the actual health emergency. The COVID-19 crisis, the important prevalence of smartphones and high speed internet during confinement should be viewed as an opportunity to promote a major shift in CR programs with the use of telemedicine to advance the health of a larger number of individuals with cardiac disease. The COVID-19 is a highly contagious respiratory disease caused by a new respiratory 39 virus, the SARS-CoV2 coronavirus. In mid-June 2020, the World Health Organisation 40 reported that more than 7.4 million cases of COVID19 were confirmed worldwide with 41 more than 418.000 deaths. Among infected patients, 15% of them develop a much more 42 severe form of the disease 1 , including ARDS (acute respiratory distress syndrome). Elderly individuals and patients with cardiovascular diseases are particularly at risk of 44 developing severe complications. The mortality rate increases sharply with age and 45 reaches 3.6% in people aged 60, 8% in people aged 70 and 14.8% in people aged over 80 46 1, 2 , these data depends on the country and constantly changing. High blood pressure, type 47 II diabetes or cardiovascular diseases are the most common comorbidities in people 48 affected by COVID-19 3 , with mortality rates particularly high from 5.6% to 10.5% 1 . To date, there is no treatment and to slow the rapid spread of the virus, most Although the proportion of eligible cardiac patients participating in CR programs is 72 generally low (range anywhere from 14% to 55% in North America 8, 9 ), its impacts on 73 individual health outcomes and the benefits for the health care system are paramount. In Characteristics of and Important Lessons From the Coronavirus 223 Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the 224 A review of the 2019 Novel Coronavirus (COVID-19) 226 based on current evidence Prevalence of comorbidities in the 228 novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis COVID-19 pandemic: what consequences for 231 cardiac rehabilitation? European 233 Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of 234 the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention Clinical Practice (constituted by representatives of 10 societies and by invited experts)Developed 236 with the special contribution of the European Association for Cardiovascular Prevention & 237 Rehabilitation (EACPR) 239 enrollment, and delivery of cardiac rehabilitation/secondary prevention programs at clinical 240 centers and beyond: a presidential advisory from the American Heart Association The benefits of cognitive 243 training after a coronary artery bypass graft surgery Use of cardiac 245 rehabilitation by Medicare beneficiaries after myocardial infarction or coronary bypass surgery Cardiac rehabilitation series: Canada. Prog 248 Cardiovasc Dis Cardiac rehabilitation for people with heart disease: an overview 250 of Cochrane systematic reviews Cardiac rehabilitation and its effects on cognition in 252 patients with coronary artery disease and heart failure Prospective 255 Associations of Accelerometer-Measured Physical Activity and Sedentary Time With Incident 256 The 258 psychological impact of quarantine and how to reduce it: rapid review of the evidence Coronavirus disease (COVID-19): 261 The need to maintain regular physical activity while taking precautions A review of telerehabilitation for 264 cardiac patients Smartphones in the secondary prevention 266 of cardiovascular disease: a systematic review Telehealth 268 interventions for the secondary prevention of coronary heart disease: A systematic review and 269 meta-analysis Medium-Term 271 Effectiveness of a Comprehensive Internet-Based and Patient-Specific Telerehabilitation 272 Program With Text Messaging Support for Cardiac Patients: Randomized Controlled Trial Effect of 275 comprehensive cardiac telerehabilitation on one-year cardiovascular rehospitalization rate, 276 medical costs and quality of life: A cost-effectiveness analysis Motivational 279 counselling for physical activity in patients with coronary artery disease not participating in 280 cardiac rehabilitation Ardissino 282 D et al. A EUropean study on effectiveness and sustainability of current Cardiac Rehabilitation 283 programmes in the Elderly: Design of the EU-CaRE randomised controlled trial Positive Effects of the Reversion of Depression 286 on the Sympathovagal Balance after Telerehabilitation in Heart Failure Patients Week Hybrid Comprehensive Telerehabilitation Program on Long-term Outcomes in Patients 291 With Heart Failure: The Telerehabilitation in Heart Failure Patients (TELEREH-HF) Randomized 292 Clinical Trial Exergaming in older adults: a scoping 294 review and implementation potential for patients with heart failure Effects of 297 exergaming on exercise capacity in patients with heart failure: results of an international 298 multicentre randomized controlled trial Telerehabilitation Compared with Traditional Cardiac and Pulmonary Rehabilitation: A 301 Systematic Review and Meta-Analysis The management of patients with chronic heart failure: the growing role of 304 e-Health MobileHeart, a mobile smartphone-based 306 application that supports and monitors coronary artery disease patients during rehabilitation