Myocarditis In Post-Covid-19 Athletes

Diagnosis Prevalence And Risks

Abstract

Covid-19, caused by the SARS-CoV-2 virus, is a systemic infection that, in addition to affecting the respiratory system, can lead to significant cardiovascular repercussions, including myocarditis — an inflammation of the heart muscle capable of causing severe arrhythmias and even sudden death, particularly in athletes. This study aimed to review scientific evidence on the occurrence of myocarditis in athletes following Covid-19 infection, emphasizing its prevalence, the diagnostic methods employed, and the implications for return to sports activities. It is an integrative literature review conducted in the PubMed, LILACS, and MEDLINE databases, covering publications between 2020 and 2025 in Portuguese and English. A total of 11 studies that met the eligibility criteria were included. The results showed a prevalence of myocarditis ranging from 0.4% to 4%, depending on the screening method used. Cardiac magnetic resonance imaging (CMR) proved to be the most sensitive exam for detecting myocardial inflammation, whereas electrocardiogram (ECG), troponin measurement, and echocardiography demonstrated lower accuracy when used in isolation. It is concluded that, although post-Covid-19 myocarditis in athletes is an infrequent event, it represents a potentially serious risk, requiring individualized protocols for evaluation and return to sports, under strict medical supervision. Continuous cardiovascular monitoring and the integrated use of clinical and imaging exams are essential to ensure the safety and physical performance of these individuals after recovery from the infection.