ABC | Volume 115, Nº2, August 2020

Statement Grossman et al. Position Statement of the Brazilian Society of Cardiology Department of Exercise Testing, Sports Exercise, Nuclear Cardiology, and Cardiovascular Rehabilitation (DERC/SBC) on Activities Within its Scope of Practice During the COVID-19 Pandemic Arq Bras Cardiol. 2020; 115(2):284-291 • Active temperature screening at the front door is recommended. • All rooms should undergo 30 minutes of general cleaning and disinfection once or twice a day. • Cleaning kits, containing single-use paper towels for immediate disposal and a specific product for disinfection of equipment (mats, dumbbells, weight machines, etc.), should be placed at strategic points in the weight training and free weight areas. • Limit the number of members in the gym at any one time and the space allocated to each member. In free-weight areas, classrooms, and other shared spaces (e.g., training areas, locker rooms), occupancy should be limited to one person per 4 m². • Use of contiguous machines should not be allowed (i.e., if one machine is in use, the next one over should be out of service). • Water cooler privileges should be limited to refilling of individual bottles. • Home and building gyms, once cleared to reopen by the health authorities, should set aside exclusive hours for residents of the same apartment or unit. Proper cleaning after use is mandatory. 29 5.5. I’ve Been Diagnosed with COVID-19 – When Can I Resume Physical Activities? Whichever regular physical activity is desired, clearance for practice is contingent upon negative PCR and clinical reassessment. Before resuming any physical activity, regardless of intensity, a pre-exercise assessment is mandatory to diagnose potential sequelae of COVID-19. 30-34 5.6. Assessment of Athletes Who Have Contracted COVID-19 • Athletes with asymptomatic infection and confirmed presence of antibodies (positive serology). • Athletes with a history of mild COVID-19-related illness (not requiring hospitalization), confirmed or suspected. • Athletes with a history of moderate-to-severe COVID- 19-related illness (requiring hospitalization), confirmed or suspected. • Athletes with a history of COVID-19 infection (regardless of severity) with evidence of myocardial injury, confirmed by one or more of the following: in-hospital ECG changes, elevation of troponin or natriuretic peptide levels, arrhythmia, or impairment of heart function. Pre-exercise assessment with ECG and additional tests (as guided by the initial assessment) is mandatory. Whenever possible, confront with findings of previous tests, with a view to screening for persistent or de novo post-infectious symptoms. Athletes who exhibited cardiac abnormalities during COVID-19 infection will require serial cardiac imaging before resuming their regular activities, and should resume these activities only gradually. In addition, all patients with cardiac involvement must be followed by a specialist. 1. Sociedade Brasileira de Cardiologia. (SBC) Recomendações ao Cardiologista para minimizar os riscos de exposição durante a pandemia de COVID-19.2020, 23março. [Acesso em24março 2020] Disponível em: https://www.portal.cardiol.br/post/comunicado-da-diretoria-de-qa-da-sbc- minimizando-a-exposi%C3%A7%C3%A3o-do-cardiologista-%C3%A0- covid-19. 2. AssociaçãoMédica Brasileira (AMB) Diretrizes AMB: COVID-19. 09 de abril de 2020. [Acesso em 09 de abril 2020] Disponível em: https://amb.org.br/ wp-content/uploads/2020/04/DIRETRIZES-AMB-COVID-19-atualizado- em-09.04.2020.pdf. 3. Gluckman TJ; American College 0f Cardiology. General Guidance on Deferring Non-Urgent CV Testing and Procedures During the COVID-19 Pandemic. ACC Clinical Guidance and Practice. Mar 24, 2020. [Acesso em 24 março 2020] Disponível em: https://www.acc.org/latest-in-cardiology/ articles/2020/03/24/09/42/general-guidance-ondeferring-non-urgent-cv- testing-and-procedures-during-the-covid-19-pandemic 4. Centers for Disease Control and Prevention (CDC) Infographic: Sequence for Putting on Personal Protective Equipment (PPE). [Acesso em 03 março 2020]Disponívelem: https://www.cdc.gov/hai/pdfs/ppe/PPE-Sequence.pdf 5. European Society of Cardiology (ESC) ESC Guidance for the Diagnosis and Management of CVDisease during theCOVID-19 Pandemic. [Acesso em28 maio 2020]. Disponível em: https://www.escardio.org/Education/COVID- 19-and-Cardiology/ESC-COVID-19-Guidance 6. Colégio Brasileiro de Radiologia e Diagnóstico por Imagem. (CRB) Recomendações gerais de prevenção de infecção pelo COVID-19 para clínicas e serviços hospitalares de diagnóstico por imagem. [Acesso em 14 março 2020. Disponível em: https://cbr.org.br/wp-content/ uploads/2020/03/CBR_Recomenda%C3%A7%C3%B5es-gerais-de- preven%C3%A7%C3%A3o-de-infec%C3%A7%C3%A3o-pelo-COVID- 19-para-cl%C3%ADnicas-e-servi%C3%A7os-hospitalares-de-diag- n%C3%B3stico-por-imagem.pdf 7. Conselho Federal de Medicina. Posição sobre a pandemia de COVID-19: contexto, análise de medidas e recomendações. 17 de março de 2020. [Acessoem18março2020].Disponívelem :http://portal.cfm.org.br/images/ PDF/covid-19cfm.pdf 8. Associação Brasileira de Medicina de Emergência (ABRAMEDE) Recomendações para Intubação Orotraqueal em pacientes portadores de COVID-19.AssociaçoBrasileiradeMedicinadeEmergência (ABRAMEDE), Associaço de Medicina Intensiva Brasileira (AMIB), Sociedade Brasileira de Cardiologia (SBC), Conselho Latino Americano de Emergências Cardiovasculares e Ressuscitação (CLARE). [Acesso em 15 abril 2020] Disponível em: https://abramede.com.br/recomendacoes-para-iot-em- pacientes-portadores-de-covid-19/. 9. Edelson DP, Sasson C, Chan PS, Atkins DL, Aziz K, Becker LB, et al. Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular CareCommittee andGetWith theGuidelines - Resuscitation Adult and Pediatric Task Forces of the American Heart Association in Collaboration with the American Academy of Pediatrics, American Association forRespiratoryCare,AmericanCollegeofEmergencyPhysicians, The Society of Critical Care Anesthesiologists, and American Society of References 290