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

2024; Bentham Science Publishers; Volume: 31; Linguagem: Inglês

10.2174/0109298673264305231025093939

1875-533X

Mohamad Amin Pourhoseingholi, Omid Yazdani, Mehdi Azizmohammad Looha, Seyed Amir Ahmad Safavi‐Naini, Romina Esbati, Saba Ilkhani, Nazanin Taraghikhah, Hamidreza Hatamabadi, Amir Sadeghi, Kamran Heidari, Negarsadat Namazi, Naghmeh Asadimanesh, Saba Hatari, Shabnam Shahrokh, Ali Solhpour, Tannaz Jamialahmadi, Raúl D. Santos, Amirhossein Sahebkar,

Computational Drug Discovery Methods

Background: 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. Materials and Methods: 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. Results:: 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). Conclusion:: 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.