Jing‑Wun Lua, Sheng‑Hsiang Mab,c,d, Wei‑Fan Oue, Hsin‑Hua Chenc,f,g,h, Tai‑Li Chenb,c*, Chung‑Chao Lianga,i*
aDepartment of Physical Medicine and Rehabilitation, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan, bDepartment of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan, cFaculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, dDepartment of Public Health, Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan, eDivision of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, fBig Data Center, Chung Hsing University, Taichung, Taiwan, gDivision of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, hDivision of General Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan, iSchool of Medicine, Tzu Chi University, Hualien, Taiwan
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Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation
Objectives: Coronavirus disease 2019 (COVID‑19) is associated with poor cardiac outcomes and an increased risk of long‑term cardiovascular disease. Long‑term cardiovascular outcomes among patients with COVID‑19 after exercise‑based cardiac rehabilitation remain largely unknown. This study aimed to investigate the long‑term cardiovascular outcomes of COVID‑19 survivors after exercise‑based cardiac rehabilitation using real‑world data. Materials and Methods: We analyzed the data from the US Collaborative Network of the TriNetX Research Database. Adults aged ≥18 years who were diagnosed with COVID‑19 between 2020 and 2022 were enrolled in this study. The comparison comprised a cohort of patients receiving exercise‑based cardiac rehabilitation and 1:1 propensity score‑matched controls. Results: The exercise‑based cardiac rehabilitation group was found to have lower risks of developing several long‑term cardiovascular outcomes than the controls, such as mortality (hazard ratio [HR] = 0.75 [0.63–0.89]), stroke (HR = 0.81 [0.68–0.94]), myocardial infarction (HR = 0.75 [0.61–0.89]), ischemic cardiomyopathy (HR = 0.86 [0.75–0.99]), heart failure (HR = 0.73 [0.65–0.83]), and nonischemic cardiomyopathy (HR = 0.78 [0.63–0.92]). Conclusion: Among COVID‑19 survivors, those undergoing cardiac rehabilitation had lower risks of cardiovascular outcomes, including mortality, stroke, myocardial infarction, ischemic cardiomyopathy, heart failure, and nonischemic cardiomyopathy, than those of controls.
Keywords: Cohort, Coronavirus disease 2019, Exercise‑based cardiac rehabilitation
