ABSTRACT
Background/Introduction: COVID-19 PANDEMIA has significant cardiovascular implications. Patients with acute or latent infection may present with myocardial injury, endothelial dysfunction and thrombotic complications. Health systems in many places have been overwhelmed and prevention has been pushed aside in favor of urgent care. In many cases, the usual activity of heart rehabilitation programmes is affected. Some programmes have stopped, some have managed to perfom e-rehailitation. Our programme stopped during confinement and restarted on face-to-face mode in June 2020 with adjustments (reduction of capacity, reduction of sessions, hygienic measures) Purpose: Our objective is to analyze the main characterisitcs and main results of the patients included on heart rehabilitation programmes inmediately before and inmediately after the beginning of COVID-19 pandemia and check if the changes made to the programme affected the results of the patients Methods: Retrospective descriptive cohort of consecutive patients admitted to cardiac rehabilitation in the second half of 2019 compared with patients who started inmediately after the pandemia beginning in our city (second half of 2020), The selection criteria are: 1) patients who have started rehabilitation within the established periods. 2) complete cardiac rehabilitation programme. Baseline, ergometric and echocardiographic characteristic are analyzed. Results: 131 patients werw included, 59 in second half 2019 group (2019 group) and 72 in the second half 2020 group (2020 group). The mean age of the 2020 group was lower, without reaching statistical significance (65 +/-13 vs 62 +/-10 p=ns). In the “2019 group” 52(88%) males were included vs 58 males (81%) included in the “2020 group”. The initial burden of cardiovascular risk factors (hypertension, diabetes, dyslipemia, smoking habit) was similar ( see Table 1). The main reason for inclusion in cardiac rehabilitation programme was ischemic heart disease in both groups (49 (83%) VS 57 (79%), p= ns), and the number of vessel affected was similar ( see Table 1). Patients with ventricular ejection fraction less than 50% were similar, too. Initial functional capacity (initial METS) and final functional capacity ( final METS) showed no differences, neither mean BMI. The initial and final lab test parameters analyzed here (LDL-choleterol and HDL-cholesterol) showed no differences between the 2 groups. Conclusion(s): Our group opted to maintain a face-to-face cardiac rehabilitation programme with adaptations (reduction of capacity, reduction of sessions, hygienic measures among others. Despite this adaptation, the baseline characteristics of the patients included, the reason for inclusion on the programme and the main results showed no differences between both groups. (Figure Presented).
ABSTRACT
Introduction: In December 2019, a new respiratory disease, named COVID-19, caused by a novel coronavirus, emerged in Wuhan and since then spread rapidly throughout China and worldwide. Hemodialysis patients are an especially vulnerable subgroup of the general population. However, there are only a few reports on the course of COVID-19 in maintenance hemodialysis patients. Case report: We describe in depth the clinical, analytical, and radiological details of 9 hemodialysis patients from a single center in Madrid (Spain) diagnosed with COVID-19. Furthermore, we describe and discuss the therapeutic aspects and the patients’ outcomes. Discussion: We present one of the first case series of chronic hemodialysis patients with COVID-19. Between March 14 and April 8, 2020, out of 76 prevalent patients in our hemodialysis unit, 9 (11.8%) patients were diagnosed with COVID-19. The most common symptoms were fever (77.8%), asthenia (77.8%), cough (55.6%), and dyspnea (33.3%). A total of 3 patients developed severe pneumonia, whereas 4 patients developed mild pneumonia. In 2 patients, no pathologic changes were found on chest radiography. All patients presented lymphopenia. While 6 (66.7%) patients required hospitalization, none of them was admitted to intensive care unit. The most common treatments used were azithromycin (100%), hydroxychloroquine (66.7%), lopinavir/ritonavir (55.6%) and β-interferon (22.2%). In general, we observed a mild to moderate severity of disease in our case series. One patient died, however due to a cause not related to COVID-19.