Pocket Rehab: Mhealth-based Rehabilitation Program For Patients With Cardiovascular Disease As Prevention And Treatment Strategy For Covid-19 Victims: An International Collaborative Multicentre Research Trial

According to the World Health Organization (WHO) , Cardiovascular Diseases (CVDs) are responsible for approximately 17 million deaths per year, being the cause number 1 of deaths worldwide and considered the major public health problem. In Europe, CDVs account for 45 % of all deaths . In the context of the COVID-19 pandemic, the CDVs figure in the list of groups of elevated risks . Among the reasons, it is known that the pathophysiological mechanism of the coronavirus SARS-CoV-2 uses the angiotensin converting enzyme 2 (ACE2) as a functional receptor, a surface molecule that is localised on the endothelial cells of arteries and veins, increasing the risk of contamination and the mortality rate CVD population. In countries such as Brazil, according to the epidemiological bulletin of COE-COVID19 of the Ministry of Health, among the 1124 deaths recorded until 11 April 2020, in those under the age of 60, 82.5% had illness associated CVDs. In order to mitigate the risks for these patients, multi professional cardiopulmonary and metabolic rehabilitation program has been presented as an essential therapeutic and preventive strategy, with a positive impact on cardiorespiratory capacity and quality of life, adherence to clinical treatment, impacting on the reduction of cardiovascular disease risk factors and hospital admissions. Traditional cardiac rehabilitation (CR) is usually performed in a single outpatient center and involves a structured exercise program (usually 3 sessions per week for 36 total sessions) supervised by trained physicians, nurses, and exercise therapists. As an alternative method, home-based CR involves prescribed exercises that can be carried out in a variety of settings and can be delivered "mostly or entirely outside of the traditional CR setting". Recently, the popularization of technologies such as internet and mobile phones have enabled Mobile health (mHealth) tools. MHealth can be defined as the use of mobile and wireless technologies to support the achievement of health objectives, such as surveillance, diagnosis, and management of chronic diseases [4]. The use of mHealth interventions has the potential to support successful management of chronic conditions and health behavior by: (1) improving patient self-monitoring and management, (2) building social networks for patients, (3) informing health care professionals of patients' health status, (4) providing indirect feedback interactions, (5) tailoring care and education to patient needs, and (6) improving communication among health care professionals. Considering the current and undefined social distance scenario period, and to prevent and treat of CVD population during Covid-19 pandemic, we propose a cardiopulmonary and metabolic rehabilitation program based on mobile technology (mHealth). This program can counteract the new dysfunctions occasioned by this virus and avoid the demand for services face-to-face, dropping contamination and mortality.