Results
Nine hundred and ninety-one patients were included in the study. The
mean age was 61.640±17.003 and 544 (54.89%) and 447 (45.11%) of the
patients were male and female, respectively. Four hundred and twenty-one
patients (42.48%) received atorvastatin whereas five hundred and
seventy (57.52%) did not. Of those who received atorvastatin, 169
(40.14%) were taking the medication prior to hospital admission and
atorvastatin was initiated for the rest of the patients on the first day
of hospital admission.
Regarding demographics, patients who received atorvastatin were older
(P<0.001), but no significant differences were observed in
gender distribution and BMI between the two groups. Considering
comorbidities, except for diabetes and CKD which were more prevalent in
patients who did not receive atorvastatin (P<0.001), others
including hypertension(P<0.001), coronary artery disease
(P<0.001), and malignancy (P=0.012) were significantly higher
in the group of patients who received atorvastatin. From laboratory data
collected at baseline, C reactive protein was significantly higher in
the group of patients who received atorvastatin (P=0.040). Patients who
did not receive atorvastatin had a higher baseline erythrocyte
sedimentation rate, serum creatinine, and urea levels compared to those
who did not. Except for hydroxychloroquine (P=0.005) and corticosteroids
(P=0.007), there were no significant differences between the two groups
in medications used to treat COVID-19. Baseline demographics, clinical
and laboratory data are presented in Table 1 .
Based on the crude analysis, no significant differences observed in
mortality rate between two groups (26.84% vs 25.09%, P=0.221).
Patients who received atorvastatin had a significantly lower hospital
length of stay (P<0.001). Also, this group had a lower but
non-significant need for mechanical ventilation (P=0.563). Results for
primary and secondary outcomes are represented in Table 2 .
In unadjusted COX proportional analysis, atorvastatin was associated
with a decreased in-hospital mortality (0.820[0.639-1.054]) and need
for mechanical ventilation (0.709[0.486-1.034]). Stepwise COX
regression proportional hazard ration analysis revealed that
atorvastatin is associated with reduced risk of in-hospital mortality
(0.679[0.517-0.890]) and the need for mechanical ventilation
(0.602[0.401-0.903]), independently. From demographics, age,
obesity, coronary heart disease, and malignancy included in the
multivariable analysis to evaluate the need for invasive mechanical
ventilation. Also, utilization of beta-blockers, ACEIs/ARB,
atorvastatin, corticosteroid, hydroxychloroquine, and
lopinavir/ritonavir were analyzed. In the stepwise model for the
analysis of survival, age, hypertension, coronary heart disease,
malignancy, and medication i.e., beta-blockers, ACEIs/ARB, atorvastatin,
corticosteroid, hydroxychloroquine, and lopinavir/ritonavir remained in
the multivariable model. The Association of factors with mortality and
the need for invasive mechanical ventilation in COX proportional
analysis is represented in Table 3.