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).