Coronavirus disease 2019 (COVID-19) may deteriorate the clinical status of subjects with underlying cardiovascular (CV) diseases and cause several de novo CV complications, including heart failure, myocardial infarction, myocarditis, takotsubo syndrome, life-threatening arrhythmias, and thromboembolic events.

Persistent subclinical cardiac damage after COVID-19 resolution has been reported, but whether this finding may affect long-term outcome is still poorly understood.

Myocardial tissue fibrosis and ongoing inflammation, mediated by several mechanisms, may be responsible for ventricular dysfunction and arrhythmias during follow-up.

Correct etiologic diagnosis of myocardial injury during hospitalization may allow for more proper therapeutic and follow-up strategies including second-level imaging modalities. After the acute phase, active surveillance is mandatory in any patient.

Although difficult to routinely perform after COVID-19 recovery, cardiac magnetic resonance should be considered in subjects with high clinical probability of cardiovascular sequelae at follow-up.