Background: The COVID-19 pandemic has affected more than 170 million people around the world, and previous studies of complications and long-term effects of SARS-CoV-2 infection have found that patients who are hospitalized with COVID-19 have more than double the rate of arrhythmias, including atrial fibrillation and atrial flutter, a similar rapid rhythm that can lead to heart failure and stroke. Objective: The aim of the study was to evaluate the left atrial structural remodeling in patients with persistent dyspnea and exertional dyspnea post covid 19 infections. Patients and methods: This case-control study included a total of 60 patients in sinus rhythm, aged > 18 years, attending at Department of Cardiology, Zagazig University Hospitals. They were divided into two groups :(A) included 30 symptomatic subjects recovered from covid 19 who developed exertional dyspnea, compared to group B (30) volunteers without any symptoms. All participants were in sinus rhythm. Results: Left Atrial (LA) reservoir Strain is decreased in post covid in cases with exertional dyspnea & associated with this dyspnea at odds ratio (OR) of 3.28 (95% CI 1.4 to 7.6), ALSO, LA diameter at OR of 2.7 CI (1.22- 6.77) & p wave dispersion at OR 126 CI (20- 813). Conclusion: It could be concluded that LAS parameters have a high feasibility to predict symptomatic subjects who developed exertional dyspnea, and fatigue after recovery from covid-19 infection.