Survival of the hospitalized patients with COVID‐19 receiving atorvastatin: A randomized clinical trial

Abstract

As statins decrease the progression of sepsis and its related mortality, this study aimed to evaluate the effect of atorvastatin on survival and symptom improvement in hospitalized patients with COVID‐19. This randomized controlled trial was performed on 156 hospitalized patients with COVID‐19 in Bojnourd city in 2021. Patients were randomly divided into comparison (standard therapy: hydroxychloroquine + Kaletra®) and intervention groups (atorvastatin 20 mg, SD, plus standard therapy). The main outcomes were the rate of symptom improvement, duration of hospitalization, need for intubation, and mortality rate. In this study, seven patients died, two patients (2.6%) in the comparison group and five (6.6%) in the intervention group. The mean hospitalization days ( p = 0.001), the pulse rate ( p = 0.004), and the frequency of hospitalization in the ICU ward (18.4% vs. 1.3%) were longer and greater in the intervention group. The remission probability in the comparison group was greater ( p = 0.0001). The median hospitalization days in the intervention group was longer ( p < 0.001) and remission in the comparison group occurred 1.71 times sooner (hazard ratio = 1.70, 95% confidence interval = 1.22–2.38, p = 0.002). Totally, adding atorvastatin to the standard regime in this study increased hospitalization days and imposed negative effects on symptom improvement in hospitalized patients with COVID‐19.

Atorvastatin for Reduction of 28-day Mortality in Sever and Critical COVID-19 Patients: A Randomized Controlled Trial

“…9 On the other side, another randomized controlled trial suggested that 20 mg atorvastatin per day increased the length of hospital stay (4 days vs. 6, P = 0.001) and the risk of ICU admission (18.4% vs. 1.3%). 21 A high dose of atorvastatin (40 mg) appears to be safe in severe COVID-19 cases. The placebo group had four patients drop out, whereas the Atorvastatin group had one patient experience a signi cant increase in liver enzymes.…”

“…On June 2nd, 2021, we received IRB approval (No. R. 21.04.1300) at Mansoura University, Faculty of Medicine.…”

Effects of statins on clinical outcomes in hospitalized patients with COVID-19

“…Search strategy yielded 496 potentially relevant records and six fulltext articles were assessed for eligibility. Five RCTs [2][3][4][5][6] were selected for the meta-analysis (Supplementary file) and a total of 1132 patients were included, 556 in the intervention group and 576 in the control group (placebo or standard protocol). Of the included trials, four used atorvastatin (20 mg/day [2,3] or 40 mg/day [4,5]) and one used rosuvastatin (40 mg/day) [6] as treatment for hospitalized patients with COVID-19 (Supplementary file).…”

“…Five RCTs [2][3][4][5][6] were selected for the meta-analysis (Supplementary file) and a total of 1132 patients were included, 556 in the intervention group and 576 in the control group (placebo or standard protocol). Of the included trials, four used atorvastatin (20 mg/day [2,3] or 40 mg/day [4,5]) and one used rosuvastatin (40 mg/day) [6] as treatment for hospitalized patients with COVID-19 (Supplementary file). Overall, the RCTs had a low risk of selection and attrition bias, but 40% presented a potential risk for performance, detection, and reporting bias.…”

Statin Therapy to Improve Outcome of COVID-19 Patients: Useful or Not Useful?

“…Inconsistent with these results, an RCT showed deleterious effects of statins in hospitalized COVID-19 patients. Atorvastatin in addition to standard care delayed symptom improvement and subsequently increased hospitalization length (1.71-fold delayed remission; HR, 1.70; 95% CI, 1.22–2.38; p = 0.002) [ 46 ].…”