Pocket Rehab - mHealth-based Rehabilitation Program for patients with cardiovascular disease as a prevention and treatment strategy for victims of COVID-19: an international multicentric collaborative study.

Introduction and Context: Cardiovascular diseases continue to be the main cause of mortality, with an estimated prevalence of 422.7 million cases worldwide and with a high health cost. Patients with cardiovascular disease or risk factors for cardiovascular disease have been affected more severely and more frequently by the new coronavirus due to the pathophysiological mechanisms of infection that use the angiotensin-converting enzyme 2 (ACE2) as a functional receptor for virus replication, an enzyme this which is expressed in excess in these patients. This worsened the previous scenario of underutilization of cardiovascular rehabilitation programs (CVR) before the Pandemic, requiring optimized CVR alternatives, such as those based on mobile applications (mHeath), not only because it generates well-established benefits, Objectives: Study 1: Develop a mobile application to support an optimized cardiovascular rehabilitation (RCV) program (capable of also evaluating patients recovered from COVID-19) in the home environment. Study 2: To evaluate the effects of a home RCV program based on the mHealth application, in patients with cardiovascular disease after recovery of COVID-19 and without COVID-19 in physical and biopsychosocial aspects. Study 3: Identify the main pulmonary, cardiovascular and muscular dysfunctions; and the factors associated with primary and secondary clinical outcomes in patients with cardiovascular disease after recovery of COVID-19 at different stages, compared to those without COVID-19. Method: Study 1 - Qualitative, concordance and reproducibility study. The application based on mobile technology (mHealth), will be developed by the Interdisciplinary Center for Security, Reliability and Trust (SnT) of the University of Luxembourg (C4), integrating internationally recognized instruments, such as the EXPERT Tool - Hasselt University and the PACERProject - Exercise and post-acute rehabilitation Covid-19 - University of Miami. The application will be tested and evaluated by experienced health professionals at the three research centers in the study - University of Brasilia (C1), University of Miami (C2) and Hasselt University (C3). The application will be provided to the centers. flexibility and daily monitoring of physical activity on an activity monitor with heart rate monitor). It is expected that 150 patients will be evaluated at each center (C1-C3) during the RCT study, according to local investments. Study 3 - Prospective Cohort - As a legacy of the clinical study, patients will be followed for 12 months, with the aim of identifying the main dysfunctions and factors associated with primary clinical outcomes (main events - mortality and hospitalizations secondary to a cardiac event) and secondary (hospitalizations secondary to other causes) in patients with cardiovascular disease recovered from different stages of COVID-19 compared to those without COVID -19, as well as the association between those who received the G1 or G2 intervention.