BackgroundCardiovascular magnetic resonance (CMR) and electrocardiographic (ECG) abnormalities after coronavirus disease 2019 (COVID-19) are widely reported. However, the absence of pre-infection assessments limits causal inference from these studies. This study aims to compare interval change in CMR and ECG measures in participants with incident COVID-19 and matched uninfected controls in UK Biobank.MethodsUK Biobank participants with documented COVID-19 who had CMR and ECG performed before the pandemic were invited for repeat assessment, along with uninfected participants matched on age, sex, ethnicity, location, and date of baseline imaging. Automated pipelines were used to extract ECG phenotypes and CMR measures of cardiac structure and function, aortic distensibility, aortic flow, and myocardial native T1. Logistic regression was used to examine associations of baseline metrics with incident COVID-19. Standardized residual approach was used to compare the degree of interval change in CMR and ECG metrics between cases and controls.ResultsWe analyzed 2092 participants (1079 cases and 1013 controls) with average age of 60 ± 7 years. 47.1% were male. There was 3.2 ± 1.5 years between pre- and post-infection assessments. 3.6% of cases were hospitalized. Lower baseline left ventricular ejection fraction and worse longitudinal, circumferential, and radial strain were associated with higher risk of incident COVID-19. There were no significant differences in interval change of any CMR or ECG metric between cases and controls.ConclusionWhile pre-existing cardiovascular abnormalities are linked to higher risk of COVID-19, exposure to infection does not alter interval change of highly sensitive CMR and ECG indicators of cardiovascular health.