The impact of the COVID-19 pandemic on centre-based cardiac rehabilitation outcomes: An interrupted time series analysis

Abstract

Abstract We sought to assess how the coronavirus-19 (COVID-19) pandemic affected the quality of centre-based cardiac rehabilitation (CR). Data CR outcomes for 1,452 patients (mean age 59 years, 77% men) were extracted from the National CR Registry and aggregated over monthly time units. We constructed an interrupted time-series (52 months with breakpoint March 2020) with segmented regression to estimate change in level (% points) and trend (% points/month) with 95% confidence intervals [95%CI] of selected CR outcomes. The outbreak of COVID-19 pandemic affected the majority of selected outcomes. We detected a significant increase in level (6.97; 95%CI 0.32, 13.6%, p=0.040) and trend (0.79; 95% 0.21, 1.36%, p=0.008) for smoking; a significant decrease in level for health-related quality of life (-16.3; 95%CI -27.2, -5.4%, p=0.005); a significant increase in trend for exercise capacity (1.68; 95%CI 0.51, -2.85%/month, p=0.006), and decrease in trends for triglyceride control (-1.46; 95%CI -0.61,-2.31%/month, p<0.001), systolic blood pressure control (-1.93; -3.05, -0.81%/month, p<0.001), high-potency statins uptake (-1.21; 95%CI -1.81,-0.61%/month, p<0.001), and BMI (-1.46; 95%CI -2.48, -0.45, p=0.006). The COVID-19 pandemic has affected the quality of centre-based CR. Especially unfavourable trends in risk factors and lifestyle measures should be intensively addressed in the post-pandemic period.