CMR findings:
A total of 480 myocardial segments of the thirty patients were evaluated. Sixteen patients of the 30 (53.3%) had abnormal CMR findings in terms of increased T2 signal and/or LGE (Figure 2 and Figure 3). Myocardial edema was reported in 12 (40%) patients while 10 (33.3%) patients had LGE. Majority of the patients had a focal linear sub-epicardial LGE (6/10; 60%) while patchy mid-wall LGE was reported in 4 (40%) [Figure 3]. Most of the LGE lesions were localized in the inferior, infero-septal segments at base and mid-LV cavity level. None of the subjects in the healthy controls had any LGE on CMR. A diagnosis of active myocarditis based on the revised LLC14 was made in 7/30 (23.3%) individuals. In terms of conventional left ventricular CMR parameters such as LVEF, LV end diastolic volume (EDV), LV end systolic volume (ESV) and stroke volume (SV), there was no significant difference between patients who recovered from COVID-19 and healthy controls (Table 2). However, COVID-19 recovered patients had significantly lower RVEF, RV SV and RV cardiac index (CI) as compared to healthy controls. Follow-up CMR was performed six months later in sixteen subjects who had an abnormal CMR findings. All these sixteen patients had been on medical therapy comprising beta-blockers and ACE inhibitors/ARBs. Of the sixteen subjects, follow-up scan was abnormal in four of them (25%) with LGE persisting in three individuals (Figure 4) while one had raised myocardial T2 value. Of the four patients with abnormal CMR on follow-up, moderate COVID-19 was present in one and severe COVID-19 in three individuals.