Predictors and clinical consequences of heart damage in CMR in patients after COVID-19

Methods: Out-hospital clinic patients (pts) recovered from COVID-19 were prospectively recruited and underwent cardiac magnetic resonance (CMR) examination with a protocol including: Edema, hyperemia, and necrosis or scar-derived from signal intensity assessment in T2-weighted, early gadolinium enhancement (EGE) and late gadolinium enhancement (LGE) CMR images. Result(s): A total of 702 patients (mean age 50+/-12 years, 62% female) were included. The median (IQR) time interval between COVID-19 diagnosis and CMR was 13 (8-22) weeks. In none pts signs of edema, hyperemia and necrosis derived from signal intensity assessment in T2-weighted and early gadolinium enhancement was found. LGE was found in 152 (22%). LGE+ patients had significantly lower left ventricular (LV) ejection fraction (58.5+/-7.7 vs 61.1+/-7.9%, p<0.001) and greater LV end-diastolic (117.0+/-52.2 vs 103,0+/-36.3 ml, p=0.023) and end-systolic (50.3+/-28.0 vs 41.0+/-17.5 ml, p=0.010) volumes when compared with LGE- patients. In the resting electrocardiogram (ECG) fragmented QRS was observed significantly more frequently (46% vs 25%, p<0.001) in LGE+ group, whereas in 24h Holter ECG neither single premature, nor complex ventricular extrasystole burden did not differ between groups (p>0.05). There were observed no differences between symptoms of COVD-19 and comorbidities between LGE+ and LGE- pts. In the multivariable logistic regression analysis: Fragmented QRS [OR and 95% CI: 2.85 (1.93-4.21)] and any ST-T segment deviation in resting ECG [OR: 1.93 (1.15-3.25)] were identified as independent predictors of LGE, even after adjustment for comorbidities and COVID-19 symptoms. Conclusion(s): 1. In patients with fibrosis after COVID-19 reduced left ventricular ejection fraction and greater volume of the heart was found. 2. Fragmented QRS and ST-T abnormalities were independent predictors for LGE in patients after COVID-19.

Anxiety and depression among ambulatory and hospitalized patients with cardiovascular long-COVID-19 presentation referred to cardiology consultation after COVID-19 infection

Introduction: COVID-19 is connected with varying degrees of emotional stress. Patients (pts) who are hospitalized with severe COVID-19 (C19) are located in single rooms without a permanent attendant to prevent contamination. All personnel serving these pts come into contact with patients with personal full-body protective garment. Ambulatory C19 pts, usually with less severe presentation, are treated in more comfortable conditions. Purpose(s): To evaluate the impact of the psychosocial changing conditions on individuals' psyche and to analyse the differences in terms of experienced anxiety and depression among the ambulatory and hospital patients referred to post-C19 cardiology consultation. Method(s): The study involved 388 pts with persistent cardiovascular symptoms, including 198 ambulatory patients (130 females and 68 males) and 190 hospital patients (128 females and 62 males) referred to the cardiology consultation (mean age 4.9+/-12.9 and 50.5+/-14.4 years, respectively). The data were collected using the specially designed questionnaire related to descriptive characteristics of the patients and to standardized questionnaires: The State-Trait Anxiety Inventory (STAI) and Beck's Depression Inventory (BDI). Result(s): Abnormal psychological metrics was common in the study pts. Indicators of anxiety were lower in the ambulatory than in hospitalized pts (p<0.001). Depression level was also lower in the ambulatory pts (p<0.001). The same differences were statistically significant in both female and male pts subsets. However, anxiety and depression were more pronounced among female than male pts. Very strong positive correlation was observed between anxiety - state and depression among ambulatory patients, both females and males (p<0.05). Conclusion(s): C19 convalescents with persistent symptoms of presumed cardiovascular origin present with abnormal psychological traits including increased anxiety and depression especially in individuals requiring hospital treatment. For this reason, it is necessary to plan the interventions particularly in hospitalized pts to reduce their anxiety and depression levels and to create psychological support programs.

Impact of COVID-19 pandemics upon nationwide pulmonary hypertension cohort: 18-months analysis of BNP-PL national database

Introduction: Pulmonary hypertension (PH) patients may be vulnerable to SARS-CoV-2 infection, but large analytic studies on morbidity and mortality risks are limited. Aim(s): Assessment of the incidence and course of COVID-19 among patients (pts) diagnosed with PH, treated under the NFZ program, registered in the national BNP-PL database with the assessment of the impact of the SARS-CoV-2 pandemic on the care of patients with pulmonary hypertension in Poland. Method(s): We analyzed the records of the complete population of Polish pts treated under the National Drug Program of PH (PAH and CTEPH), registered in the national database of BNP-PL, and updated on an ongoing basis by all PH centers. The frequency of SARS-CoV-2 infections, clinical severity of COVID-19 course and mortality were reviewed. Clinical characteristics of infected and deceased patients were compared to the remaining patients registered in the BNP-PL database. The rate of increase of new diagnoses ended with inclusion in the Drug Program between 01 March 2020 and 31 August 2021, compared to the pre-pandemic year 2019, and the change in the treatment profile were reviewed. Result(s): The analysis included 1923 pts (PAH 1292, CTEPH 631). The incidence of SARS-CoV-2 infections was 7.4% (n=143) and similar to general population (7.6%), with a slight preponderance in PAH 8.1% (n=105) vs. CTEPH 6.0% (n=38) (p=0.099). 47 patients (33%) required hospitalization. Mortality rate was 24% (34/143) vs. 2.6% for general population - including 19/34 outside of hospital. Those who died due to COVID-19 were older (mean age 56+/-17.6 vs. 70.5+/-12.8 yrs;p<0.0001) and had more cardiovascular comorbidities (1.35 vs. 1.97;p=0.01). Systemic arterial hypertension was the strongest unique risk factor for mortality, present in 71% decedents vs. 45% of survivors, and the only independent risk factor in multivariate logistic regression analysis (OR 2.94, 95% CI 1.28-6.73). Moreover, there was a trend towards a higher incidence of diabetes and coronary artery disease in the group of non-survivors (Table 1). The number of new diagnoses of PH decreased during the pandemic compared to 2019 (new diagnoses rate in 2019 was 28.2/month vs. 19.2/month during COVID). A significant increase in total mortality was also observed in the PH group (11.1/month in 2019 vs. 13.7/month during COVID). Escalation of specific PH therapy also reduced (rate of specific therapy escalation in 2019 was 30.4/month vs. 20.5/month during COVID). Conclusion(s): The COVID-19 pandemic has deeply affected the care of patients with pulmonary hypertension by reducing the number of new diagnoses, escalation of therapy, and increasing overall mortality in this population, and this impact continues into second year of pandemics. Pulmonary hypertension is associated with a more severe course and higher mortality in COVID-19. (Figure Presented).

The use of handheld ultrasound device in cardiac examination of patients with history of COVID-19

Background: Clinical usefulness of Handheld Ultrasound Device [HUD] was previously confirmed in numerous clinical scenarios. During the previous two years Covid-19 patients become a focal point of healthcare worldwide. The assessment of long term consequences of this infection is bound to overload already burdened healthcare system. Purpose(s): To assess clinical usefulness of HUD as an adjunct to physical cardiac examination of patients with history of COVID-19. Method(s): Study population consisted of randomly selected patients with no symptoms of cardiovascular pathology, who had been hospitalized due to COVID-19 one year prior to examination. Physical examination and clinical assessment was augmented with short examination with the use of HUD, which included: Visual evaluation of the global and regional LV function, measurement of RV size, screening for the significant valve defects and the presence of pericardial effusion. Subsequently full echocardiographic examination with the use of high-end workstation was performed, which results were treated as reference. Result(s): 54 patients (35 men, mean age 63+/-13 years) were enrolled into the study. In clinical examination no significant cardiovascular abnormalities were discovered. In 30 [56%] of patients cardiac abnormalities in HUD examination were detected. In 18 patients [33%] LV function assessment was not performed, due to insufficient quality of registered view. In the remaining group significant impairment of LV ejection fraction (<50%) was detected in HUD examination in 3 [6%] patients (2 confirmed in full examination, positive predictive value [PPV] 57%, negative predictive value [NPV] 97%, AUC 0,82+/-0,17, P 0,057). WMA were diagnosed in 6 [11%] patients (4 confirmed in full examination, PPV 84% NPV 78%, AUC 0,69+/-0,17, P 0,02). RV enlargement was identified in 21 [39%] patients (PPV 57%, NPV 97%, AUC 0,85+/-0,05, P<0,0001), mild pericardial effusion in 3 [6%] patient (1 confirmed in full echocardiographic examination;2 false positive, no false negative), at least moderate mitral/tricuspid/aortic valve insufficiency in 7 [13%] patients (3 confirmed, 4 false positive cases, no false negative). A total mean time of the heart and lungs HUD examination was 2,1+/-0,6 minute. Conclusion(s): Cardiac abnormalities exposed in brief assessment with the use HUD are a relatively common finding in asymptomatic patients previously hospitalized due to COVID infection in a 1-year follow-up, despite normal physical examination. Normal HUD examination excludes the presence of significant cardiac abnormalities with high probability. However one should keep in mind a relatively high percentage of false positive results, which may lead to an exceeding number of patients referred for a full echocardiographic examination.

The use of handheld ultrasound device in cardiac examination of patients with history of COVID-19

Background: Clinical usefulness of Handheld Ultrasound Device [HUD] was previously confirmed in numerous clinical scenarios. During the previous two years Covid-19 patients become a focal point of healthcare worldwide. The assessment of long term consequences of this infection is bound to overload already burdened healthcare system. Purpose: To assess clinical usefulness of HUD as an adjunct to physical cardiac examination of patients with history of COVID-19. Methods: Study population consisted of randomly selected patients with no symptoms of cardiovascular pathology, who had been hospitalized due to COVID-19 one year prior to examination. Physical examination and clinical assessment was augmented with short examination with the use of HUD, which included: visual evaluation of the global and regional LV function, measurement of RV size, screening for the significant valve defects and the presence of pericardial effusion. Subsequently full echocardiographic examination with the use of high-end workstation was performed, which results were treated as reference. Results: 54 patients (35 men, mean age 63±13 years) were enrolled into the study. In clinical examination no significant cardiovascular abnormalities were discovered. In 30 [56%] of patients cardiac abnormalities in HUD examination were detected. In 18 patients [33%] LV function assessment was not performed, due to insufficient quality of registered view. In the remaining group significant impairment of LV ejection fraction (<50%) was detected in HUD examination in 3 [6%] patients (2 confirmed in full examination, positive predictive value [PPV] 57%, negative predictive value [NPV] 97%, AUC 0,82±0,17, P 0,057). WMA were diagnosed in 6 [11%] patients (4 confirmed in full examination, PPV 84% NPV 78%, AUC 0,69±0,17, P 0,02). RV enlargement was identified in 21 [39%] patients (PPV 57%, NPV 97%, AUC 0,85±0,05, P<0,0001), mild pericardial effusion in 3 [6%] patient (1 confirmed in full echocardiographic examination;2 false positive, no false negative), at least moderate mitral/tricuspid/aortic valve insufficiency in 7 [13%] patients (3 confirmed, 4 false positive cases, no false negative). A total mean time of the heart and lungs HUD examination was 2,1±0,6 minute. Conclusion: Cardiac abnormalities exposed in brief assessment with the use HUD are a relatively common finding in asymptomatic patients previously hospitalized due to COVID infection in a 1-year follow-up, despite normal physical examination. Normal HUD examination excludes the presence of significant cardiac abnormalities with high probability. However one should keep in mind a relatively high percentage of false positive results, which may lead to an exceeding number of patients referred for a full echocardiographic examination. Funding Acknowledgement: Type of funding sources: None.

The prognostic value of speckle tracking echocardiography in patients hospitalized with COVID-19

Introduction: In COVID-19 patients, both preexisting cardiovascular disease as well as cardiac injury resulting from SARS-CoV-2 infection are associated with increased mortality. We hypothesized that novel parameters of myocardial function may be useful in the assessment of in-hospital and long-term prognosis. Aim: The aim of study was to determine the prevalence of myocardial dysfunction revealed by speckle tracking echocardiography and its association with in-hospital and one-year mortality. Methods: The study group comprised 192 patients hospitalized in the cardiology department due to COVID-19. All patients underwent transthoracic echocardiographic examination with off-line analysis. Using speckle tracking technique, we measured the following parameters: left ventricular global longitudinal strain (GLS), right ventricular global longitudinal strain (RV-GLS), right ventricular free wall strain (RV-FWS) and myocardial work parameters – global work index (GWI), global wasted work (GWW), global constructive work (GCW) and global work efficiency (GWE). The primary outcome was in-hospital and one-year mortality. Results: 112 patients (mean age 68±14 years, 76 (68%) male) had adequate image quality to evaluate strain-derived parameters. 27 patients died during hospitalization and 44 patients died within one-year after discharge. In-hospital non-survivors were older, had lower baseline oxygen saturation (SpO2) and had higher NTproBNP (Table 1). In non-survivors speckle-tracking echocardiography revealed significant impairment of left and right ventricular function compared to the group of survivors (Table 1). The independent predictors of in-hospital death were GWE (OR 0.85;95% CI 0.78–0.93) and SpO2 on admission (OR 0.91;95% CI 0.86–0.96). Based on the ROC curve analysis, the optimal cut-off points for predicting in-hospital death were identified: GWE ≤87% (sensitivity 63%, specificity 89%) and baseline SpO2 value ≤88% (sensitivity 81%, specificity 71%).The independent predictors of one-year mortality were: age (OR 1.28 [1.13–1.46]), NTproBNP (OR 1.002 [1.001–1.003]), baseline SpO2 (OR 0.71 [0.59–0.86]) and RV-GLS (OR 1.32 [1.12–1.55]). Based on the ROC curve analysis, the cut-off points optimal for predicting death within 12 months after COVID-19 were also identified: baseline SpO2 value ≤88% (sensitivity 69.8%, specificity 77.3%), age >60 years (sensitivity 90%, specificity 43%), NTproBNP >500 pg/ml (sensitivity 95%, specificity 41.8%), RV-GLS >−18.5 (sensitivity 93%, specificity 64.2%). Conclusions: Two-dimensional speckle tracking echocardiography is a useful technique to evaluate myocardial function in COVID-19 patients and provides good prognostic value for identifying patients at risk of death during hospitalization and in long term follow-up. Funding Acknowledgement: Type of funding sources: None.

Atrial fibrillation as a risk factor of severe course of COVID-19

Background: Coronavirus disease (COVID-19), the pandemic caused by severe acute respiratory syndrome coronavirus, influences on morbidity and mortality and results in changes of human life. It seems that comorbidities play a vital role in severe course of COVID- 19. Nevertheless, how chronic diseases affect respiratory failure is poorly validated. Purpose: Our aim was to compare the severity of the course of COVID-19 and the prognosis in patient with and without atrial fibrillation (AF). Methods: We analyzed 199 patients (72 female, mean age 67±13 years) with COVID-19 hospitalized in our Department since November 2020, including, 68 patients with AF (28 female, mean age 74.5±8 years). Although, only 45 patients took anticoagulants before, the treatment was initiated to all patients with AF on admission to the hospital. Patients with AF were characterized by lower left ventricle ejection fraction than those without AF (49% vs. 54%, p=0.0007). Results: The severe course of COVID, defined as saturation below 90%, lung involvement above 50% in computer tomography, the need for highflow oxygen therapy, was noticed in 98 patients (36 pts with AF, 32 pts without AF, p=0.27). Moreover, there was no difference between the groups among separately the need for high- flow oxygen therapy, saturation below 90% and lung involvement above 50% in computer tomography. The absence of atrial fibrillation, with a significance of p=0.01, predisposes to a better prognosis based on the patient's discharge. In multivariate analysis, the factors suggesting a poor prognosis, defined as death or transfer to Intensive Care Unit, were severe course of COVID (p=0.01) and the need for high- flow oxygen therapy (p=0.042). Conclusions: It is noticed that the presence of AF is associated with a poor prognosis in COVID. Further analysis is still needed to prove this statement.

Clinical profile and in hospital mortality of invasively managed patients with suspicion of acute coronary syndrome during the COVID-19 pandemic

Background: The pandemic of COVID-19 significantly changed the treatment of patients with suspicion of ACS and COVID-19 infection. Access to cardiology department and possibility of invasive diagnosis and treatment of ACS are still significantly impaired. Aim: Our aim was to evaluate the characteristic and prognosis of patients with suspicion of ACS and COVID-19 infection. Materials and methods: Our department of cardiology was transformed for Covid unit and was dedicated for diagnosis and treatment of patients with suspicion of ACS. COVID-19 confirmed cases were defined by a positive SARS-CoV-2 polymerase chain reaction (PCR) test. From 14th of October 2020 to 14th of March we performed 39 coronary angiographies. We included 39 patients (27 men) with mean age 69±8.5. In that group 11 patients had NSTEMI, 10 patients had STEMI, 2 patients Tako-Tsubo and 16 unstable angina. All patients underwent coronary angiography, and in 27 patients we performed PCI. Results: In hospital mortality rate was 35% (14 patients). Cardiac arrest was present in 3 (8%) patients and cardiogenic shock in 4 (10%) patients. The rate of NSTEMI was higher in patients who died 7 vs 4 (p=NS) and STEMI were comparable in both groups 4 vs 6, (p=ns). The IL 6 levels in patients who died were 389±278pg/mL, in compare to 101±93pg/mL (p=0.3) who survived. Independent predictors of death were: sex with the OR=1,1 (95% CI: 0.6-2.4), p=0,03 and IL-6 level on admission OR=1,4 (95% CI: 0.6-2.4), p=0,04. There were no statistically significant differences regarding age, left ventricle ejection fraction, CRP levels and oxygen saturation od admission. Conclusion: This study confirms the higher risk of death in patients with ACS and SARS-CoV-2. In the multivariable analysis only sex and Il-6 level on admission were the independent risk factors of the in hospital death. Further investigations of the underlying physiopathological relations between COVID-19 and ACS are needed.

Impact of COVID-19 pandemics upon pulmonary hypertension patients: insights from BNP-PL national database

Introduction: COVID-19 pandemic has caused not only an increase in overall and cardiovascular mortality, but also hindered access to health care, diagnosis and treatment of diseases other than coronavirus infection. Aim: Assessment of the impact of the SARS-CoV-2 pandemic on the rate of diagnosis and therapy of pulmonary hypertension (PH) in Poland, along with an analysis of the incidence and course of COVID-19 among patients (pts) diagnosed with PH, treated under the National Health Fund program, registered in the national BNP-PL database. Methods: The records of the complete population of Polish pts treated under the National Drug Program of PH (PAH and CTEPH), registered in the national database of BNP-PL, updated on an ongoing basis by all PH centers, were analyzed. The frequency of SARS-CoV-2 infections, the clinical severity of their course and the mortality were reviewed, taking into account the specific therapies used. The basic clinical characteristics of the group of sick and deceased patients were compared to the remaining patients registered in the BNP-PL database. The rate of increase of new diagnoses ended with inclusion in the Drug Program between March and December 2020, compared to the corresponding periods of the previous year, and the change in the treatment profile were compared. Results: The analysis included 1704 pts (PAH 1134, CTEPH 570). The incidence of SARS-CoV-2 infections was 3.8% (n=65), including PAH 2.7% (n=46) and CTEPH 3,2% (n=18). 32 patients (49%) required hospitalization. Mortality rate was 28% (18/65) - including 7/18 outside of hospital. Those who died due to COVID-19 were older (mean age 68.4±l15.8 vs. 50.8±l18.8 yrs;p<0,001), had higher WHO class and more cardiovascular comorbidities (4±l2,06 vs. 2,66±l1,8;p=0,01) (Table 1). During the pandemic the number of new diagnoses of PH markedly decreased compared to the corresponding period in 2019 (total 150 vs. 203, PAH 90 vs. 123, CTEPH 60 vs. 80, respectively). A significant increase in total mortality was also observed in the PH group (9,72 vs. 5,85%). Moreover, escalation of specific PH therapy decreased significantly (14,7% vs. 21,6%). Incidence of COVID-19 study group was lower than estimated for general Polish adult population (3,8% vs. 6,5%). Conclusions: COVID-19 pandemic deeply influenced the diagnostic and therapeutic process of pulmonary hypertension by reducing the number of new diagnoses, escalation therapy and increased overall mortality in this population. This may be due in part to the conversion of some PAH centers into hospitals treating patients infected with SARS-CoV-2, as well as to patients' fear of admitting to hospital despite clinical deterioration. Pulmonary hypertension is linked to markedly increased mortality in COVID-19, similarly for PAH and CTEPH. Intriguing finding of lower infection rate may be linked to protective lifestyle or specific therapies.

Pocket-size ultrasound devices may improve the prompt assessment of Covid-19 patients

Introduction: Clinical usefulness of pocket-size ultrasound device [PSUD] was previously confirmed in numerous clinical scenarios. During the previous year Covid-19 patients have become a focal point of the cardiology and internal medicine wards. However, there is no data on the use of PSUD in this scenario. Purpose: To asses if PSUD may be useful in providing additional information in Covid-19 patients. Methods: In 63 patients (41 men, mean age 63±11) with confirmed Covid- 19 the scope of physical examination was expanded with bedside assessment performed with PSUD equipped with dual probe. PSUD examination included: right ventricle measurement, automated LVEF assessment, 4-point compression ultrasound test of lower limbs and lung ultrasound (presence of B-lines, lung consolidations or thickening of pleura). Subsequently, within the next 24 hours all patients underwent chest CT scan, CT pulmonary angiogram and full echocardiographic examination performed on a high-end stationary device. Results: Lung lesions typical for Covid-19 were confirmed in CT in 53 (84%) patients. The sensitivity and specificity of bedside PSUD examination for diagnosing lung involvement was 92% and 90%, respectively, when presence of any pathology on lung ultrasound was considered as a positive criterion. Increased number of B-lines had a sensitivity of 81%, specificity 83% for the ground glass symptom in CT detection, (AUC 0,82;p<0,0001). Pleural thickening was diagnosed by PSUD with a 95% sensitivity and 88% specificity (AUC 0,91, p<0,0001), whereas lung consolidations with a 71% sensitivity and 86% specificity (AUC 0,79, p<0,0001). In 20 patients (32%) pulmonary embolism was confirmed by angioCT - in 10 among them embolism was limited to subsegmental arteries. RV was found to be dilated in PSUD examination in 27 patients (43%), CUS was positive in 1 patient. Thus, RV enlargement treated as a marker of PE had low sensitivity and specificity (60% i 65% respectively), AUC=0,62, p=0,06. Mean LVEF in standard echocardiography was 46±12%, but during PSUD examination automated LV function analysis software failed to calculate LVEF in 29 (46%) cases due to suboptimal image quality. Conclusion: In Covid-19 patients PSUD is particularly useful for lung ultrasound and the detection of lung pathologies. RV enlargement observed during PSUD examination has relatively low sensitivity and specificity for the detection of pulmonary embolism in Covid-19. Furthermore, due to low quality of images automated LV function assessment failed to provide any result in almost half of patients.

What can we find in the ECG recording in convalescent from COVID-19 with mild and moderate course

Despite the fact that most people with COVID-19 (C-19) do not require hospitalization, little is known about the changes in ECG in this group of patients (pts). The electrocardiogram (ECG) is one of the leading tools to assess the extent of cardiac involvement in C-19 pts. Our main aim was to asses ECG abnormalities related to cardiac involvement in patients without hospitalization with mild and moderate course of C-19 . Methods: Only pts without co morbidities, not taking any medications were included to the study. In all pts standard 12-lead electrocardiograms (EKG) mean 8,2week +/- 4,6) after C-19 was performed in supine position after 15 minutes in rest. The following parameters were analyzed: mean heart rate (mHR), bradycardia and tachycardia episodes defined as HR <40bpm and HR> 100 bpm, PQ duration, QRS durations, the Bazett-corrected QT interval, changes in the ST-T segment and the T wave. Additionally heart rhythm disturbances were assessed and atrial fibrillation/flutter episodes, the presence of atrial premature contractions (APCs), ventricular premature contractions VES) Number of atrioventricular blocks, bundle branch blocs (BBB) - (RBBB, LBBB, a nonspecific intraventricular conduction block) were also analyzed. Results: 264 pts were included to final assessment, with mean age 43,5 ± 13,5 years. The results were as follow: HR <40bpm - in 0pts, HR> 100 bpm in 9(3%)pts, PQ duration > 200ms in 7(3%)pts, QRS durations > 100ms in 19(6%)pts, QTc interval in 16 (6%)pts, ST-T segment abnormalities in 21(8%)pts and the T wave abnormalities in16(6%)pts Following heart rhythm disturbances were noted: AF/AFl in 0pts, (APCs) in 0pts, VES - in 3(1%)pts. No episodes of atrioventricular blocks were recorded, but BB in bundle branch blocs (BBB) - (RBBB, LBBB, a nonspecific intraventricular conduction block) in 14 (3%) pts were noted. Conclusions. The most frequent ECG abnormalities in pts without co-morbidities after COVID-19 without hospitalization were ST-T segment and T abnormalities. A large number of changes in ECG confirms that we can expect cardiac involvement also in the group of patients with mild and moderate course of COVID-19.