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Atorvastatin therapy in COVID-19 adult inpatients: A double-blind, randomized controlled trial
Lotfollah Davoodi1, Hamed Jafarpour2, Ziaeddin Oladi3
1Department of Infectious Diseases, School of Medicine, Antimicrobial Resistance Research Center, Communicable Diseases Research Institutes, Ghaem Shahr Razi Hospital, Mazandaran University of Medical Sciences, Sari, Iran.
Insights
Atorvastatin combined with lopinavir/ritonavir significantly reduced C-reactive protein levels and hospitalization duration in adults with COVID-19 compared to lopinavir/ritonavir alone.
Area of Science:
- Infectious Diseases
- Pharmacology
- Clinical Medicine
Background:
- The urgent need for effective treatments for coronavirus disease 2019 (COVID-19) necessitates evaluating novel therapeutic strategies.
- Hospitalized adult patients with COVID-19 require interventions to improve clinical outcomes and reduce disease severity.
Purpose of the Study:
- To assess the efficacy of atorvastatin in conjunction with standard care for hospitalized adult patients diagnosed with COVID-19.
- To compare the effects of atorvastatin plus lopinavir/ritonavir against lopinavir/ritonavir alone on key clinical markers and hospitalization duration.
Main Methods:
- A randomized controlled clinical trial was conducted involving hospitalized adult COVID-19 patients.
- Participants were randomized to receive either atorvastatin plus lopinavir/ritonavir or lopinavir/ritonavir monotherapy.
- Primary outcome: duration of hospitalization. Secondary outcomes: need for interferon/immunoglobulin, mechanical ventilation, C-reactive protein (CRP) levels, and oxygen saturation (O2sat).
Main Results:
- Forty patients were enrolled; demographic and clinical characteristics were similar between groups.
- The atorvastatin group showed a significant reduction in CRP levels (P < 0.0001) and hospitalization duration (P = 0.012).
- No significant differences were observed in O2sat, need for interferon/immunoglobulin, or invasive mechanical ventilation between the groups.
Conclusions:
- Combination therapy with atorvastatin and lopinavir/ritonavir appears more effective than lopinavir/ritonavir alone in managing hospitalized COVID-19 patients.
- Atorvastatin may play a beneficial role in reducing inflammation and shortening hospital stays for COVID-19 patients.
Introduction:
Efficacious therapies are urgently required to tackle the coronavirus disease 2019 (COVID-19). This trial aims to evaluate the effects of atorvastatin in comparison with standard care for adults hospitalized with COVID-19.
Methods:
We conducted a randomized controlled clinical trial on adults hospitalized with COVID-19. Patients were randomized into a treatment group receiving atorvastatin + lopinavir/ritonavir or a control group receiving lopinavir/ritonavir alone. The primary outcome of the trial was the duration of hospitalization. The secondary outcomes were the need for interferon or immunoglobulin, receipt of invasive mechanical ventilation, and O2 saturation (O2sat), and level of C-reactive protein (CRP) which were assessed at the onset of admission and on the 6th day of treatment.
Results:
Forty patients were allocated and enrolled in the study with a 1 to 1 ratio in atorvastatin + lopinavir/ritonavir and lopinavir/ritonavir groups. Clinical and demographic characteristics were similar between the two groups. CRP level was significantly decreased in the lopinavir/ritonavir + atorvastatin group (P < 0.0001, Cohen's d = 0.865) so that there was a significant difference in CRP level on the 6th day between the two groups (P = 0.01). Nevertheless, there was no significant difference in O2sat on day 6. Although the duration of hospitalization in the lopinavir/ritonavir + atorvastatin group was significantly reduced compared to the control group (P = 0.012), there was no significant difference in the invasive mechanical ventilation reception and the need for interferon and immunoglobulin.
Conclusion:
Atorvastatin + lopinavir/ritonavir may be more effective than lopinavir/ritonavir in treating COVID-19 adult hospitalized patients.
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