Covid-19 pandemic's impact on management of cardiovascular risk factors in a Phase IIIs period of a cardiac rehabilitation program, fact or fiction?
Authors: Tojal Sierra L , Soria Navarro R , Juanes Dominguez I , Saez De Buruaga E , Virosta Gil E , Fernandez Fernandez De Leceta Z , Apodaca Arrizabalaga M J , Gomez Corcuera E , Manzabal Gonzalez C , Conde Lagartos A I , Pasalodos Heras L M , Para Barbero E , Arana Monte M , Bello Mora M C , Alonso Gomez A M 
Published: October 2021

Abstract

Introduction
The global pandemic due to Covid-19 has constituded a challenge in the follow up and monitoring of cardiac rehabilitation's programs. The State of alarm declared last year in Spain, led to strict home confinement that could have had an impact in the progress of patients

Aim
To analyze the effect of home confinement on the managment of cardiovascular risk factors (CVRF) in patients included in phase III of a cardiac rehabilitation program (CRP) and also to evaluate the self-care education received during CRP.

Methods and materials
Descriptive, comparative and retrospective analysis of patients in phase III of a CRP. The sample was divided into two groups: Post-Covid group (consecutive CRP patients with follow up one year after the cardiac event from 6/21/2020 [date of end of home confinement in Spain] to 12/31/2020) and Group Pre-Covid (consecutive CRP patients with follow up one year after the cardiac event from 6/21/2019 to 12/31/2019). Demographic and CVRF data from end of phase II consultation were compared with those from the phase III consultation (one year after the event) for both groups. The SPSS statistics v23 program was used for statistical analysis.

Results
283 patients, 137 patients from the pre-Covid group and 146 patients from the post-Covid group. No statistically significant differences were found between the two populations (Table 1).
No statistically significant differences were found in the achievement of the CVRF target values: systolic blood pressure &lt;140mmHg (94 vs 107; p=0.216), diastolic blood pressure &lt;90mmHg (121 vs 130, p=0.276), LDL-c &lt;70 mg/dl (86 (71.7%) vs 89 (73.6%); p=0.743), LDL-c &lt;55 mg/dl (41 (34.2%) Vs 47 (38.8%); p=0.451), HbA1c figure &lt;7% (106 vs 111; p=0.478), baseline fasting blood glucose &lt;110 mg/dl (103 vs 107; p=0.970).
Regarding the variation of the CVRF figures between the final consultation of phase III and that of phase II, no statistically significant differences were found between the two groups: difference in LDL-c figure for phase III consultation with respect to phase II (−0.5±20.3 mg/dl in pre-Covid group vs −5.3±24.4 mg/dl in post-Covid group; p=0.102), difference in HDL-c (4.6±26.1 mg/dl pre-Covid group vs −0.6±24.9 mg/dl post-Covid group; p=0.113), difference in total cholesterol level (4.6±26.1 mg/dl vs −0.6±24.9 mg/dl; p=0.113), difference in HbA1c (0.1±0.3% in pre-Covid group vs 0.1±0.6% in group post-Covid), Table 2.

Conclusions
Home confinement has not contribute to a worsening in CVRF control in patients in a phase III of a CRP, in our study.
The education given in a CRP concerning to the management of CVRF is the essential factor that grant an adequate patient control in extraordinary circumstances.

Funding Acknowledgement
Type of funding sources: None.