Promising effects of atorvastatin on mortality and need for mechanical ventilation in patients with severe COVID‐19; a retrospective cohort study

Abstract

Purpose Considering the anti‐inflammatory effect of atorvastatin and the role of medical comorbidities such as hypertension and coronary artery disease on the prognosis of the COVID‐19 patients, we aimed to assess the effect of atorvastatin add‐on therapy on mortality caused by COVID‐19. Methods We conducted a retrospective cohort study, including patients who were hospitalised with confirmed diagnosis of severe COVID‐19. Baseline characteristics and related clinical data of patients were recorded. Clinical outcomes consist of in‐hospital mortality, need for invasive mechanical ventilation and hospital length of stay. COX regression analysis models were used to assess the association of independent factors to outcomes. Results Atorvastatin was administered for 421 of 991 patients. The mean age was 61.640 ± 17.003 years. Older age, higher prevalence of hypertension and coronary artery disease reported in patients who received atorvastatin. These patients have shorter hospital length of stay ( P = .001). Based on COX proportional hazard model, in‐hospital use of atorvastatin was associated with decrease in mortality (HR = 0.679, P = .005) and lower need for invasive mechanical ventilation (HR = 0.602, P = .014). Conclusions Atorvastatin add‐on therapy in patient with severe COVID‐19 was associated with lower in‐hospital mortality and reduced the risk of need for invasive mechanical ventilation which supports to continue the prescription of the medication.

Association of Statins for Primary Prevention of Cardiovascular Diseases With Hospitalization for COVID‐19: A Nationwide Matched Population‐Based Cohort Study

“…This finding is consistent with that observed in numerous studies. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 …”

“…In total, 36 of 49 studies (73%) show a lower risk of severe COVID‐19 outcomes––in particular mortality––among statin users compared with nonusers. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 In 11 studies, ratio measures were close to 1. 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 In 2 studies, an increased risk was observed.…”

Effect of Ivermectin and Atorvastatin on Nuclear Localization of Importin Alpha and Drug Target Expression Profiling in Host Cells from Nasopharyngeal Swabs of SARS-CoV-2- Positive Patients

“…Along the same line, statins have prominent in vivo effects on endothelial cell biology and it has been discussed whether they would be able to act on vascular dysfunction associated with COVID-19 [49]. Considering its role in hypertension and coronary disease, ATV was assessed retrospectively in severe COVID-19 patients having comorbidities, with good results in terms of reducing the need for mechanical ventilation and in-hospital mortality [50].…”

Phenotypical and Functional Alteration of γδ T Lymphocytes in COVID-19 Patients: Reversal by Statins

“…Several studies suggest that statins may play a role in the treatment of SARS-CoV-2 infection, mainly by reducing complications due to pre-existing atherosclerotic cardiovascular disease and preventing acute lung injury [ 57 , 58 , 59 ]. Indeed, several observational clinical studies and meta-analyses have demonstrated a significant protective effect of statins in COVID-19 patients, administrated before or during hospitalization, reducing the risk of the need for invasive mechanical ventilation, mortality, ARDS, and hospital stay [ 3 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 ]. Overall, these studies suggest that this class of drugs may represent an important choice for adjuvant therapy in the treatment of these patients, influencing their course favorably.…”