SARS-CoV-2, the cause of the COVID-19 pandemic, is a novel RNA virus that is transmitted by respiratory droplets/aerosols. Cardiovascular complications can occur according to 2 patterns of myocardial injury: either by indirect inflammatory response without cardiac symptoms, or predominant cardiac involvement such as fulminant myocarditis, arrhythmia, or other cardiovascular manifestations. Because of these concerns, it is important for the cardiology community to be cognizant of the possible cardiovascular manifestations of COVID-19. These concerns have been heightened in athletes. The apprehension regarding sudden cardiac arrest (SCA) — the leading medical cause of fatalities in athletes during sports and exercise - increases as more high-profile athletes get infected with COVID-19 and potentially develop myocarditis. While being across a line of scrimmage or in the locker room may increase the risk of transmission, it is unknown how many athletes infected with SARS-CoV-2 will develop cardiac complications. This uncertainty represents a large, empty hole in our knowledge of COVID-19. The concern is that exercise after COVID-19 infection may lead to an increased incidence of SCA or development of cardiomyopathy over time. Moving forward, our goal is to navigate these uncharted waters3 in order to maximize the physical, mental, and social benefits of sports while minimizing unnecessary restriction.
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