Exercise Training and Cardiac Rehabilitation in COVID-19 Patients with Cardiovascular Complications: State of Art

Abstract

Recent scientific literature has investigated the cardiovascular implications of COVID-19. The mechanisms of cardiovascular damage seem to involve the protein angiotensin-converting enzyme 2 (ACE2), to which severe acute respiratory syndrome (SARS) coronavirus-2 (CoV-2) binds to penetrate cells and other mechanisms, most of which are still under study. Cardiovascular sequelae of COVID-19 include heart failure, cardiomyopathy, acute coronary syndrome, arrhythmias, and venous thromboembolism. This article aims to collect scientific evidence by exploiting PubMed, Scopus, and Pedro databases to highlight the cardiovascular complications of COVID-19 and to define the physiotherapy treatment recommended for these patients. Exercise training (ET), an important part of cardiac rehabilitation, is a powerful tool in physiotherapy, capable of inducing significant changes in the cardiovascular system and functional in the recovery of endothelial dysfunction and for the containment of thromboembolic complications. In conclusion, due to the wide variety of possible exercise programs that can be obtained by combining intensity, duration, and speed in various ways, and by adjusting the program based on continuous patient monitoring, exercise training is well suited to the treatment of post-COVID patients with an impaired cardiovascular system of various degrees.

Associations between the Severity of the Post-Acute COVID-19 Syndrome and Echocardiographic Abnormalities in Previously Healthy Outpatients Following Infection with SARS-CoV-2

“…Some authors highlighted the important role of cardio-pulmonary rehabilitation programmes [27], with exercise training being a powerful tool in physiotherapy, having the capacity to induce significant improvements in the respiratory and CV systems, facilitating the functional recovery of the respiratory musculature and of the cardiac performance, as well as the reduction of the endothelial dysfunction and of thromboembolic complications [28]. Another aspect is the impact of cardio-pulmonary rehabilitation on the functional capacity, quality of life and prognosis [29].…”

The Effects of Reduced Physical Activity on the Lipid Profile in Patients with High Cardiovascular Risk during COVID-19 Lockdown

“…In patients with dyslipidemia and previous COVID-19 infection, exercise training can be an important part of cardiac rehabilitation, capable of inducing significant changes in the cardiovascular system and functional in the recovery of endothelial dysfunction and for the containment of thromboembolic complications [35]. Therefore, although several studies have shown that home programs involving low or moderate to vigorous intensity exercises have been shown to be safe and effective for patients with stable cardiovascular disease, care should be taken when prescribing home training for patients at high risk [36][37][38].…”

Epidemiology, risk factors and prognosis of cardiovascular disease in the Coronavirus Disease 2019 (COVID-19) pandemic era: a systematic review

“…A recent review described an exercise-based rehabilitation program, physiotherapy airway clearance techniques, and techniques focused on ventilation and dyspnea management from existed literature and studies in non-COVID-19 patients [71]. However, it lays the foundations for future research to develop exercisebased rehabilitation and guidelines in COVID-19 survivors [72][73][74]. In any case, exercise is a valuable therapeutic approach with various benefits for respiratory, cardiovascular, and musculoskeletal systems, and future guidelines will be important tools for healthcare workers [75][76][77][78].…”