Impact of Prior COVID-19 Infections on Cardiac Rehabilitation Completion Rates and Outcomes

Abstract

Purpose: This is a retrospective cohort study designed to evaluate the impact of having a prior coronavirus disease 2019 COVID-19 infection on cardiac rehabilitation (CR) completion rates and outcomes. Methods: Participants enrolled into the CR program from June 1, 2020 to March 30, 2022. They completed both physical and mental health assessments prior to enrollment and upon completion of the program. The cohort was divided into (–) COVID and (+) COVID based on whether they self-reported a prior COVID-19 infection. Outcome measures included General Anxiety Disorder-7, Patient Health Questionnaire-9, Mental Composite Score (Short Form Health Survey-36), Physical Composite Score (Short Form Health Survey-36), and exercise capacity (reported in metabolic equivalents). Program completion rates and outcome measures were compared between (–) COVID and (+) COVID cohorts. Results: A total of 806 participants were enrolled in the study. Program completion rates were 65% in the (–) COVID group and 72% in the (+) COVID group (P = .105). African Americans (P = .003), participants with diabetics (P = .003), and current smokers (P < .001) were less likely to complete the program. Both (–) COVID and (+) COVID groups showed significant improvement in all outcome measures after completing the CR program. However, there was no difference in outcomes between groups. Conclusions: Having a prior COVID-19 infection did not negatively impact the mental and physical health benefits obtained by completing the CR program, regardless of the American Association of Cardiovascular and Pulmonary Rehabilitation risk category.