On January 30, 2020, the World Health Organization (WHO) stated that the outbreak of coronavirus disease 2019 (COVID-19) caused by the new coronavirus (SARS-CoV-2) constituted a "public health emergency of international concern" — the highest-level alert issued by the organization, as provided for in the International Health Regulations. Compared to SARS-CoV, which caused an outbreak of severe acute respiratory syndrome (SARS) in 2003, SARS-CoV-2 has greater transmission potential. The rapid increase in confirmed cases has made COVID-19 prevention and control extremely important. The Brazilian Ministry of Health received the first report of a confirmed case of COVID-19 in Brazil on February 26, 2020; on March 11, 2020, WHO declared the disease a pandemic, leading to an urgent need to seek knowledge and solutions as quickly as possible for both treatment and prevention. The pandemic led to preventive and restrictive measures worldwide, which were different across countries and continents depending on COVID-19 outcomes in each region. As infection rates decline, less strict restrictions are being implemented for sports and exercise. COVID-19 has been associated with a significant number of cardiovascular complications, reaching approximately 16% of patients. However, there is a lack of long-term data, especially on active individuals and competitive athletes. Based on the established knowledge about common viral myocarditis, it is known that there may be sequelae affecting physical performance and leading to greater occurrence of sudden death (SCD) during exercise, as they constitute an arrhythmogenic substrate in the myocardium. This position statement aims to warn against the risk of cardiac impairment and its possible sequelae in patients with COVID-19 as well as to provide guidance on the need for post-disease cardiological evaluation before returning to sports, including proposed strategies for SCD prevention using targeted cardiovascular preparticipation screening (PPS).
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