Comparative Efficacy of Atorvastatin and Placebo in Intensive Care Unit Patients with Coronavirus Disease 2019: A Randomized Controlled Trial.

Abstract

Objective: Statins, recognized for their lipid-lowering properties, are being studied in clinical studies for potential benefits in treating coronavirus disease 2019 (COVID-19). This clinical trial evaluated the efficacy of a moderate dose of atorvastatin in influencing the clinical response among critically ill COVID-19 patients.

Methods: This investigation involved adult individuals diagnosed with laboratory-confirmed COVID-19 and experiencing critical illness. Patients meeting the eligibility criteria and receiving atorvastatin were allocated to continue treatment at a daily dosage of 20 mg (PHA). In contrast, the remaining eligible patients were randomly assigned to the atorvastatin intervention (AIN: administration of 20 mg atorvastatin daily) and control groups. Patients followed up for 14 days for the primary endpoints of the COVID-19 severity and APACHE II scores. The secondary endpoints and different biochemical parameters were also assessed.

Findings: Finally, 116 people completed the study. The studied groups had no significant differences regarding the demographic and basic clinical data. C-reactive protein on the 7^th and 14^th days in the AIN and PHA groups was significantly lower than in the control group (P = 0.008 and P = 0.018). IL6 on the 7^th day (P = 0.04) showed a significant decrease in AIN compared to PHA and control groups. However, no significant differences in APACHE-II score and disease severity were detected between the groups.

Conclusion: Atorvastatin could effectively reduce inflammation in intensive care unit (ICU) patients admitted for COVID-19 management, but it could not influence the clinical outcomes. We suggested investigating its effect on COVID-19 in larger sample sizes, nonICU patients, and from the beginning of the diagnosis for a longer duration.