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

Mariaconsiglia Calabrese, Marina Garofano, Roberta Palumbo, Paola Di Pietro, Carmine Izzo, Antonio Damato, Eleonora Venturini, Severino Iesu, Nicola Virtuoso, Andrea Strianese, Michele Ciccarelli, Gennaro Galasso, Carmine Vecchione, Mariaconsiglia Calabrese, Marina Garofano, Roberta Palumbo, Paola Di Pietro, Carmine Izzo, Antonio Damato, Eleonora Venturini, Severino Iesu, Nicola Virtuoso, Andrea Strianese, Michele Ciccarelli, Gennaro Galasso, Carmine Vecchione

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.

Keywords: COVID-19; cardiovascular; rehabilitation.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic representation of the renin–angiotensin system and the function of the Mas receptor. Abbreviations: AT1, angiotensin II type 1 receptor; AT2, angiotensin II type 2 receptor; ACE, angiotensin-converting enzyme; ACE2, angiotensin-converting enzyme 2.

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