The battle against COVID-19 has entered a new phase with Rehabilitation Centres being among the major players, because the medical outcome of COVID-19 patients does not end with the control of pulmonary inflammation marked by a negative virology test, as many patients continue to suffer from long-COVID-19 syndrome. Exercise training is known to be highly valuable in patients with cardiac or lung disease, and it exerts beneficial effects on the immune system and inflammation. We therefore reviewed past and recent papers about exercise training, considering the multifactorial features characterizing post-COVID-19 patients’ clinical conditions. Consequently, we conceived a proposal for a post-COVID-19 patient exercise protocol as a combination of multiple recommended exercise training regimens. Specifically, we built pre-evaluation and exercise training for post-COVID-19 patients taking advantage of the various programs of exercise already validated for diseases that may share pathophysiological and clinical characteristics with long-COVID-19.

Several epidemiological studies have consistently reported inverse associations between cardiorespiratory fitness and the risks of cardiovascular disease and mortality

Background/Objectives: Pericardial effusion (PEf) is a frequent finding after cardiac surgery. Progression to cardiac tamponade (CT) is a rare but life-threatening complication. Current evidence remains limited due to insufficient data on prevalence, progression predictors and management strategies. Methods: We retrospectively analyzed anamnestic, clinical, laboratory, echocardiographic and therapeutic data from 2662 patients (74 ± 11 years) admitted to the Cardiac Rehabilitation ward between 2022 and 2024. Results: Among 2152 (81%) cardiac surgery patients, 382 (18%) developed PEf: 58% mild, 38% moderate, and 4% severe. Patients developing PEf tended to be younger and more frequently male. In addition, PEf development was seen more commonly after aortic and combined surgeries. All patients with severe PEf or CT had undergone surgery via sternotomy, whereas minithoracotomy was inversely associated with PEf severity. Postoperative complications occurred in 92% of PEf patients, mainly due to arrhythmia, hemodynamic deterioration, or heart failure. Overall outcome was favourable in 98% of patients. CT occurred in eight patients (2%). Anticoagulation therapy was more frequent among patients who developed PEf or CT. Preventive colchicine was prescribed in only 16% of cases. No PEf-specific therapy was administered in 56% of PEf patients, while corticosteroids and nonsteroidal anti-inflammatory drugs were used in 28% and 8% of cases, respectively, without surgical wound complications. No PEf recurrences were observed during follow up (517 ± 424 days). Conclusions: PEf is a common complication after cardiac surgery, more frequently in young males, usually of mild or moderate severity. The majority of these cases resolve using either a conservative or pharmacological approach, predominantly via corticosteroids. Patients undergoing aortic surgery, experiencing postoperative complications (especially arrhythmias), and receiving anticoagulation therapy were associated with severe PEf or CT. Despite guideline recommendations, colchicine remains markedly underutilized.

Background/Objectives: Postoperative atrial fibrillation (POAF) is a common complication of coronary artery bypass grafting (CABG) and may recur during cardiac rehabilitation (CR); its long-term prognostic value remains unclear. We evaluated the impact of POAF on a composite endpoint of all-cause mortality and non-fatal stroke after isolated CABG and assessed POAF duration and timing, AF recurrence, and other predictors of adverse outcomes. Methods: This multicentre retrospective study enrolled 1139 patients who underwent CR after isolated CABG between 2011 and 2015 across 17 Italian centres. Clinical and outcome data were obtained from medical records and structured interviews; median follow-up was 5.78 years. Results: POAF occurred in 34.3% of patients and was associated with a higher incidence of the primary composite endpoint of all-cause mortality and non-fatal stroke in univariate analysis (15.4% vs. 10.0%, p = 0.008), particularly when lasting ≥48 h or occurring during both surgery and rehabilitation. However, in multivariate analysis POAF was not an independent predictor; instead, CHA₂DS₂-VASc score ≥3, reduced left ventricular ejection fraction, elevated urea, history of heart failure, and AF recurrence during follow-up predicted adverse outcomes. Conclusions: POAF reflects early vulnerability but does not independently predict long-term mortality or stroke. Conversely, AF recurrence and CHA₂DS₂-VASc score retain strong prognostic value, underscoring the need for long-term rhythm monitoring and individualised risk assessment post-CABG.