text: COVID and Cardiovascular Disease What We Know in 2021 Coronavirus disease 2019 COVID 19 has been the cause of significant global morbidity and mortality Here we review the literature to date of the short term and long term consequences of Severe Acute Respiratory Syndrome Coronavirus 2 SARS CoV 2 infection on the heart Early case reports described a spectrum of cardiovascular manifestations of COVID 19 including myocarditis stress cardiomyopathy myocardial infarction and arrhythmia However in most cases myocardial injury in COVID 19 appears to be predominantly mediated by the severity of critical illness rather than direct injury to myocardium from viral particles While cardiac magnetic resonance imaging remains a powerful tool for diagnosing acute myocarditis it should be used judiciously in light of low baseline prevalence of myocarditis Guiding an athletic patient through return to play RTP after COVID 19 infection is a challenging process More recent data show RTP has been a safe endeavor using a screening protocol Long COVID or post acute sequelae of SARS CoV 2 infection has also been described The reported symptoms span a large breadth of cardiopulmonary and neurologic complaints including fatigue palpitations chest pain breathlessness brain fog and dysautonomia including postural tachycardia syndrome POTS Management of POTS dysautonomia primarily centers on education exercise and salt and fluid repletion Our understanding of the impact of COVID 19 on the cardiovascular system is constantly evolving As we enter a new age of survivorship additional research is needed to catalogue the burden of persistent cardiopulmonary symptoms Research is also needed to learn how acute management may alter the likelihood and prevalence of this chronic syndrome 