Exercise rehabilitation associates with lower mortality and hospitalisation in cardiovascular disease patients with COVID-19

The COVID-19 pandemic has caused global health, social, and economic system challenges. In an effort to try and reduce transmission rates, most countries have varying levels of societal 'lockdowns' and social restrictions in place. This creates a unique challenge for the promotion of physical activity and exercise, which we know has profound physical and mental health benefits. Although there was initial promise of increased population interest in physical activity and exercise at the beginning of the COVID-19 pandemic, 1 recent large-scale data from over 455 000 people has demonstrated a 27% decrease in average daily steps within 30 days of the pandemic declaration. t may therefore be more important now than ever to facilitate physical activity and exercise promotion during and post-COVID-19. Despite, recent collaborative efforts developing post-COVID-19 guidelines for athletes returning to exercise, 3 limited evidence is available for the impact of exercise and cardiac rehabilitation (CR) on clinical outcomes following-COVID-19. Secondary prevention through comprehensive CR has been recognized as the most costeffective intervention to ensure favourable outcomes across a wide spectrum of cardiovascular diseases. Given there is a high prevalence of cardiovascular disease among patients with COVID-19, and >7% experience COVID-19 induced myocardial injury, 5 CR following COVID-19 infection warrants investigation. The objective of this study was therefore to compare mortality, hospitalization, and cardiovascular comorbidity between patients with cardiovascular disease and COVID-19 with and without an electronic medical record (EMR) of CR or exercise programmes.