We investigated impacts of COVID-19 on cardiac rehabilitation (CR) delivery around the globe, including virtual delivery, as well as effects on providers and patients. In this cross-sectional study, a piloted survey was administered to CR programs globally via REDCap from April to June 2020. The 50 members of the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) and personal contacts facilitated program identification. Overall, 1062 (18.3% program response rate) responses were received from 70/111 (63.1% country response rate) countries in the world with existent CR programs. Of these, 367 (49.1%) programs reported they had stopped CR delivery, and 203 (27.1%) stopped temporarily (mean = 8.3 ± 2.8 weeks). Alternative models were delivered in 322 (39.7%) programs, primarily through low-tech modes (n = 226,19.3%). Furthermore, 353 (30.2%) respondents were re-deployed, and 276 (37.3%) felt the need to work due to fear of losing their job, despite the perceived risk of contracting COVID-19 (mean = 30.0% ± 27.4/100). Also, 266 (22.5%) reported anxiety, 241(20.4%) were concerned about exposing their family, 113 (9.7%) reported increased workload to transition to remote delivery, and 105 (9.0%) were juggling caregiving responsibilities during business hours. Patients were often contacting staff regarding grocery shopping for heart-healthy foods (n = 333, 28.4%), how to use technology to interact with the program (n = 329, 27.9%), having to stop their exercise because they have no place to exercise (n = 303, 25.7%), and their risk of death from COVID-19 due to pre-existing cardiovascular disease (n = 249, 21.2%). Respondents perceived staff (n = 488, 41.3%) and patient (n = 453, 38.6%) personal protective equipment, as well as COVID-19 screening (n = 414, 35.2%), and testing (n = 411, 35.0%) as paramount to in-person service resumption. Given the estimated number of CR programs globally, these results suggest approximately 4400 CR programs globally have ceased or temporarily stopped service delivery. Those that remain open are implementing new technologies to ensure their patients receive CR safely, despite the challenges.

Background: COVID-19 (COronaVIrus Disease-19) control measure stringency, including testing, has been among the highest globally in China. Psychosocial impact on pandemic workers in Shanghai and their pandemic-related attitudes were investigated. Methods: Participants in this cross-sectional study were health care providers (HCPs) and other pandemic workers. A Mandarin online survey was administered between April and June 2022 during the omicron-wave lockdown. The Perceived Stress Scale and Maslach Burnout Inventory were administered. Results: Eight hundred eighty-seven workers participated, of which 691 (77.9%) were HCPs. They were working 6.25 ± 1.24 days per week for 9.77 ± 4.28 hours per day. Most participants were burned out, with 143 (16.1%) moderately and 98 (11.0%) seriously. The Perceived Stress Scale score was 26.85 ± 9.92 of 56, with 353 participants (39.8%) having elevated stress. Many workers perceived benefits: cohesive relationships (n = 581 [65.5%]), resilience (n = 693 [78.1%]), and honor (n = 747 [84.2%]). In adjusted analyses, those perceiving benefits showed significantly less burnout (odds ratio, 0.573; 95% confidence interval, 0.411 to 0.799), among other correlates. Conclusions: Pandemic work, including among non-HCPs, is highly stressful, but some can derive benefits.

This cross-sectional study investigated health management, well-being, and pandemic-related perspectives in Shanghainese adults ≥50 years at the early stages of COVID-19 using a self-report survey in March–April, 2020. Items from the SSS, PHQ-9 and GAD-7 were administered. A total of 1181 primarily married, retired females participated. Many participants had hypertension (44.1%), coronary artery disease (CAD; 17.8%), and diabetes (14.5%). While most (n = 868, 73.5%) were strictly following control measures and perceived they could tolerate >6 months (n = 555, 47.0%) and were optimistic (n = 969, 82.0%). A total of 52 (8.2%) of those with any condition and 19 (3.5%) of those without a condition reported that the pandemic was impacting their health. Somatic symptoms were high (29.4 ± 7.1/36), with sleep/cognitive symptoms highest. Totals of 20.2% and 17.0% of respondents had elevated depressive and anxious symptoms, respectively; greater distress was associated with lower income (p = 0.018), having hypertension (p = 0.001) and CAD (p < 0.001), negative perceptions of global COVID-19 control (p = 0.004), COVID-19 spread (p < 0.001), impact on life/health (p < 0.001), compliance with control measures (p < 0.001), and the toleration of shorter time control measures (p < 0.001) in adjusted analyses. In conclusion, during the initial COVID-19 outbreak, most older adults were optimistic/resilient regarding the epidemic and control measures. However, the distress of older adults was not trivial, particularly in those with health issues.

Background COVID-19 and associated controls may be particularly problematic in the context of chronic conditions. This study investigated health management, well-being, and pandemic-related perspectives in these patients in the context of stringent measures, and associated correlates. Methods A self-report survey was administered via Wenjuanxing in Simplified Chinese between March-June 2022 during the Omicron wave lockdown in Shanghai, China. Items from the Somatic Symptom Scale (SSS) and Symptom Checklist-90 (SCL-90) were administered, as well as pandemic-related items created by a working group of the Chinese Preventive Medical Association. Chronic disease patients in this cross-sectional study were recruited through an associated community family physician group. Results Overall, 1775 patients, mostly married females with hypertension, participated. Mean SSS scores were 36.1±10.5/80, with 41.5% scoring in the elevated range (i.e., above 36). In an adjusted model, female, diagnosis of coronary artery disease and arrhythmia, perceived impact of pandemic on life, duration can tolerate control measures, perception of future & control measures, impact of pandemic on health condition and change to exercise routine due to pandemic were significantly associated with greater distress. Approximately one-quarter (24.5%) perceived the pandemic had a permanent impact on their life, and 44.1% perceived at least a minor impact on their health. One-third (33.5%) discontinued exercise due to the pandemic. While 47.6% stocked up on their medications before the lockdown, their remaining supply was mostly only enough for a couple of weeks and 17.5% of participants discontinued use. Chief among their fears were inability to access healthcare (83.2%), and what they stated they most needed to manage their condition was medication access (65.6%). Conclusions Since 2020 when we assessed a similar cohort, distress and perceived impact of the pandemic has worsened. Greater access to cardiac rehabilitation in China could address these issues.