Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era

Marco Ambrosetti; Ana Abreu; Veronique Cornelissen; Dominique Hansen; Marie Christine Iliou; Hareld Kemps; Roberto Franco Enrico Pedretti; Heinz Voller; Mathias Wilhelm; Massimo Francesco Piepoli; Chiara Giuseppina Beccaluva; Paul Beckers; Thomas Berger; Costantinos H. Davos; Paul Dendale; Wolfram Doehner; Ines Frederix; Dan Gaita; Andreas Gevaert; Evangelia Kouidi; Nicolle Kraenkel; Jari Laukkanen; Francesco Maranta; Antonio Mazza; Miguel Mendes; Daniel Neunhaeuserer; Josef Niebauer; Bruno Pavy; Carlos Peña Gil; Bernhard Rauch; Simona Sarzi Braga; Maria Simonenko; Alain Cohen-Solal; Marinella Sommaruga; Elio Venturini; Carlo Vigorito

doi:10.1093/eurjpc/zwaa080

Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era

Marco Ambrosetti (Corresponding author), Ana Abreu, Veronique Cornelissen, Dominique Hansen, Marie Christine Iliou, Hareld Kemps, Roberto Franco Enrico Pedretti, Heinz Voller, Mathias Wilhelm, Massimo Francesco Piepoli, Chiara Giuseppina Beccaluva, Paul Beckers, Thomas Berger, Costantinos H. Davos, Paul Dendale, Wolfram Doehner, Ines Frederix, Dan Gaita, Andreas Gevaert, Evangelia KouidiNicolle Kraenkel, Jari Laukkanen, Francesco Maranta, Antonio Mazza, Miguel Mendes, Daniel Neunhaeuserer, Josef Niebauer, Bruno Pavy, Carlos Peña Gil, Bernhard Rauch, Simona Sarzi Braga, Maria Simonenko, Alain Cohen-Solal, Marinella Sommaruga, Elio Venturini, Carlo Vigorito

Eindhoven MedTech Innovation Center

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

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.

Original language	English
Pages (from-to)	541-557
Number of pages	17
Journal	European Journal of Preventive Cardiology
Volume	28
Issue number	5
DOIs	https://doi.org/10.1093/eurjpc/zwaa080
Publication status	Published - 14 May 2021

Keywords

COVID-19/epidemiology
Cardiac Rehabilitation/methods
Cardiovascular Diseases/epidemiology
Comorbidity
Consensus
Delphi Technique
Humans
Pandemics
SARS-CoV-2
Cardiovascular disease
COVID-19
Prevention
Coronavirus
Rehabilitation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1093/eurjpc/zwaa080

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Ambrosetti, M., Abreu, A., Cornelissen, V., Hansen, D., Iliou, M. C., Kemps, H., Pedretti, R. F. E., Voller, H., Wilhelm, M., Piepoli, M. F., Beccaluva, C. G., Beckers, P., Berger, T., Davos, C. H., Dendale, P., Doehner, W., Frederix, I., Gaita, D., Gevaert, A., ... Vigorito, C. (2021). Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era. European Journal of Preventive Cardiology, 28(5), 541-557. https://doi.org/10.1093/eurjpc/zwaa080

@article{e8b2acc5c49e4548bc3dfac60b34b89a,

title = "Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era",

abstract = "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.",

keywords = "COVID-19/epidemiology, Cardiac Rehabilitation/methods, Cardiovascular Diseases/epidemiology, Comorbidity, Consensus, Delphi Technique, Humans, Pandemics, SARS-CoV-2, Cardiovascular disease, COVID-19, Prevention, Coronavirus, Rehabilitation",

author = "Marco Ambrosetti and Ana Abreu and Veronique Cornelissen and Dominique Hansen and Iliou, {Marie Christine} and Hareld Kemps and Pedretti, {Roberto Franco Enrico} and Heinz Voller and Mathias Wilhelm and Piepoli, {Massimo Francesco} and Beccaluva, {Chiara Giuseppina} and Paul Beckers and Thomas Berger and Davos, {Costantinos H.} and Paul Dendale and Wolfram Doehner and Ines Frederix and Dan Gaita and Andreas Gevaert and Evangelia Kouidi and Nicolle Kraenkel and Jari Laukkanen and Francesco Maranta and Antonio Mazza and Miguel Mendes and Daniel Neunhaeuserer and Josef Niebauer and Bruno Pavy and Gil, {Carlos Pe{\~n}a} and Bernhard Rauch and {Sarzi Braga}, Simona and Maria Simonenko and Alain Cohen-Solal and Marinella Sommaruga and Elio Venturini and Carlo Vigorito",

year = "2021",

month = may,

day = "14",

doi = "10.1093/eurjpc/zwaa080",

language = "English",

volume = "28",

pages = "541--557",

journal = "European Journal of Preventive Cardiology",

issn = "2047-4873",

publisher = "Oxford University Press",

number = "5",

}

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 2021, 'Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era', European Journal of Preventive Cardiology, vol. 28, no. 5, pp. 541-557. https://doi.org/10.1093/eurjpc/zwaa080

TY - JOUR

T1 - Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era

AU - Ambrosetti, Marco

AU - Abreu, Ana

AU - Cornelissen, Veronique

AU - Hansen, Dominique

AU - Iliou, Marie Christine

AU - Kemps, Hareld

AU - Pedretti, Roberto Franco Enrico

AU - Voller, Heinz

AU - Wilhelm, Mathias

AU - Piepoli, Massimo Francesco

AU - Beccaluva, Chiara Giuseppina

AU - Beckers, Paul

AU - Berger, Thomas

AU - Davos, Costantinos H.

AU - Dendale, Paul

AU - Doehner, Wolfram

AU - Frederix, Ines

AU - Gaita, Dan

AU - Gevaert, Andreas

AU - Kouidi, Evangelia

AU - Kraenkel, Nicolle

AU - Laukkanen, Jari

AU - Maranta, Francesco

AU - Mazza, Antonio

AU - Mendes, Miguel

AU - Neunhaeuserer, Daniel

AU - Niebauer, Josef

AU - Pavy, Bruno

AU - Gil, Carlos Peña

AU - Rauch, Bernhard

AU - Sarzi Braga, Simona

AU - Simonenko, Maria

AU - Cohen-Solal, Alain

AU - Sommaruga, Marinella

AU - Venturini, Elio

AU - Vigorito, Carlo

PY - 2021/5/14

Y1 - 2021/5/14

N2 - 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.

AB - 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.

KW - COVID-19/epidemiology

KW - Cardiac Rehabilitation/methods

KW - Cardiovascular Diseases/epidemiology

KW - Comorbidity

KW - Consensus

KW - Delphi Technique

KW - Humans

KW - Pandemics

KW - SARS-CoV-2

KW - Cardiovascular disease

KW - COVID-19

KW - Prevention

KW - Coronavirus

KW - Rehabilitation

UR - http://www.scopus.com/inward/record.url?scp=85107083917&partnerID=8YFLogxK

U2 - 10.1093/eurjpc/zwaa080

DO - 10.1093/eurjpc/zwaa080

M3 - Article

C2 - 33624042

SN - 2047-4873

VL - 28

SP - 541

EP - 557

JO - European Journal of Preventive Cardiology

JF - European Journal of Preventive Cardiology

IS - 5

ER -

Delphi consensus recommendations on how to provide cardiovascular rehabilitation in the COVID-19 era

Abstract

Keywords

UN SDGs

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