Long-term cardiovascular outcomes after exercise-based cardiac rehabilitation among coronavirus disease 2019 survivors: A nationwide cohort study

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.