Before becoming mayor, Bruno Covas had served as national president of PSDB Youth and São Paulo state secretary for the environment.

In early April 2018, Covas took office as mayor after João Doria resigned to run for the state governorship in the 2018 general elections.

[4] Covas was diagnosed with gastrointestinal cancer in October 2019, in the form of an adenocarcinoma, but continued to serve as mayor while receiving chemotherapy.

In November 2020, his disease had stabilised, and Covas was elected as mayor, beating Socialism and Liberty Party (PSOL) candidate Guilherme Boulos.

[5] In May 2021, Covas was admitted to Hospital Sírio-Libanês after his cancer had spread to his liver and bones, and he requested an administrative leave of office for 30 days.

[7][8] His maternal grandfather, Mário Covas, was one of seven founders of the PSDB in 1988, and had served as governor of the state of São Paulo from 1995 until his death in 2001 due to bladder cancer.

[35][38] On 19 October 2019, Covas was taken to the emergency department at the Hospital Israelita Albert Einstein with a rash on his leg and was prescribed antibiotics.

[40] His young age and lack of risk factors prompted further investigation, which revealed an adenocarcinoma of the gastroesophageal junction with liver and regional lymph node metastases.

[40] From October through February 2020, Covas received chemotherapy with complete remission of the primary tumor, but the lymph node metastases persisted; he then began a course of immunotherapy.

[46][8] Covas died on 16 May 2021 at 08:20 BRT (11:20 UTC) of gastrointestinal cancer, aged 41,[47][46] at Hospital Sírio-Libanês in São Paulo.

[46] Encouraged by Mayor Doria, Covas adopted a strict diet and started exercising frequently, and lost over 15 kg (33 lb) as a result.

[15] Covas lived in the São Paulo district of Barra Funda [pt], having moved there when he was deputy mayor to be closer to the city centre.

[33][51] In 2020, during the pandemic, Covas lived at city hall for over two months in order to continue working while the state was under lockdown.