Background: Coronavirus disease 2019 (COVID-19) is a contagious respiratory disease that resulted from infection with a new coronavirus (SARS-CoV-2). The high prevelance of spread is the most critical issue about, millions of people have been infected all over the world, and hundreds of thousands of deaths had been recorded. Echocardiography is a commonly used noninvasive imaging tool for the assessment of cardiac pathology. Despite the limitations related to risk of performing personnel exposure, echocardiograghy can be a very useful tool for guiding management with various finding related to the cardiac COVID involvement. The aim of this study is to determine the role of transthoracic as well as speckle-tracking echocardiograghy in clinical assessement of critically ill COVID-19 patients. Method: A prospective study in which COVID-19 positive patients, admitted to quarantine of Minia University Hospital through the period from December 2019 to December 2020, underwent TTE initially then parameters were compared according to clinical deterioration. TTE and STE also were done to critically ill patients before and after remedesivir treatment. Results:  Significant differences in TAPSE values were observed between group I and group II with mean± SD: 14.85 ± 3.29 and 19.35 ± 4.01, respectively. Also, significant larger basal RV diameter in critically ill patients (mean±SD: 39.93 ± 3.08) vs (mean±SD: 38.67 ± 2.82) in clinically stable patients (p value: 0.034). all TTE and STE used parameters showed highly significant improvement in RV systolic and diastolic dysfunction after treatment with remedesivir therapy. Conclusion:  Echocardiograghy plays a crucial role in COVID-19 management. 2D TTE can be useful in predicting disease severity. Both 2D TTE and speckle tracking accurately diagnose cardiac involvement of critically ill COVID-19 patients; detect myocardial changes through course of treatment. Recovery of patients treated with antiviral remedesivir drug from severe COVID-19 illness may be accompanied with general improvement of RV systolic and diastolic dysfunction.