Atorvastatin Effect on COVID-19 Outcomes: A Propensity Score Matched Study on Hospitalized Patients.

Atorvastatin Effect on COVID-19 Outcomes: A Propensity Score Matched Study on Hospitalized Patients.

Publication date: Jan 21, 2024

This study investigated the association of atorvastatin use on survival, need for intensive care unit (ICU) admission, and length of hospital stay (LOS) among COVID-19 inpatients. A retrospective study was conducted between March 20th, 2020, and March 18th, 2021, on patients with confirmed COVID-19 admitted to three hospitals in Tehran, Iran. The unadjusted and adjusted effects of atorvastatin on COVID-19 prognosis were investigated. Propensity score matching (PSM) was used to achieve a 1:1 balanced dataset with a caliper distance less than 0. 1 and the nearest neighbor method without replacement. Of 4322 COVID-19 patients, 2136 (49. 42%) were treated with atorvastatin. After PSM, 1245 atorvastatin inpatients and 1245 controls were included with a median age of 62. 0 (interquartile range [IQR]: 51. 0, 76. 0) and 63. 0 (IQR: 51. 0, 75. 0) years, respectively. The standardized mean differences were less than 0. 1 for all confounders, suggesting a good covariate balance. The use of atorvastatin was associated with decreased COVID-19 mortality (HR: 0. 80; 95% CI: 0. 68-0. 95), whereas no relationship was found between atorvastatin and the need for ICU admission (HR: 1. 21; 95% CI: 0. 99-1. 47). LOS was significantly higher in the atorvastatin cohort than controls (Atorvastatin vs. others: 7 [5, 11] vs. 6 [4, 10] days; p = 0. 003). The survival rate was higher in combination therapy of atorvastatin plus enoxaparin than in those who received atorvastatin alone (p-value=0. 001). Atorvastatin may reduce the risk of COVID-19 in-hospital mortality and could be a beneficial option for an add-on therapy. Randomized trials are warranted to confirm the results of the current observational studies.

Concepts Keywords
Inpatients Atorvastatin; Enoxaparin
Iran COVID-19


Type Source Name
drug DRUGBANK Atorvastatin
disease MESH COVID-19
drug DRUGBANK Isoxaflutole
drug DRUGBANK Enoxaparin
drug DRUGBANK Coenzyme A

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