Limitations
We already mentioned the small sample size and the non-consecutive enrollment as main limitation of this ancillary study. In consideration of the small sample size, we thought that performing sophisticated multivariate and/or regression statistical analyses with the aim to address for confounders would have not been meaningful. Although we reported the items for the study interpretation according to the PRICES checklist, this does not rule out at all the interference of these confounders on our results. Another consideration is about the implementation of vaccination worldwide and the presence of new variants. These factors have largely influenced the circulation and the clinical course of the COVID-19 with a reduction in severe cases and drop in ICU admission. These factors should be accounted when comparing our results with future studies, as a different degree of cardiovascular impairment with new variants or as result of vaccination cannot be excluded.
CONCLUSIONS In a small single-center study, the assessment of LVDD according to latest ASE/EACVI 2016 guidelines was feasible in three quarter of COVID-19 patients admitted to ICU. Assessment with a simplified definition based on TDI values only yielded very different results. Hospital non-survivors showed a non-significant trend towards greater LVDD incidence with full assessment but not with simplified diagnostic criteria. Non-survivors had significantly worse s’ values (all) and higher E/e’ ratio (lateral).