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

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 and 14 days in the AIN and PHA groups was significantly lower than in the control group ( = 0.008 and = 0.018). IL6 on the 7 day ( = 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.