{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T06:00:59Z","timestamp":1773986459678,"version":"3.50.1"},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"07","funder":[{"name":"Rajaie Cardiovascular Medical and Research Center"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>\n            Background\u2003In the INSPIRATION-S trial, atorvastatin versus placebo was associated with a nonsignificant 16% reduction in 30-day composite of venous\/arterial thrombosis or death in intensive care unit (ICU) patients with COVID-19. Thrombo-inflammatory response in coronavirus disease 2019 (COVID-19) may last beyond the first 30 days.<\/jats:p><jats:p>\n            Methods\u2003This article reports the effects of atorvastatin 20\u2009mg daily versus placebo on 90-day clinical and functional outcomes from INSPIRATION-S, a double-blind multicenter randomized trial of adult ICU patients with COVID-19. The main outcome for this prespecified study was a composite of adjudicated venous\/arterial thrombosis, treatment with extracorporeal membrane oxygenation (ECMO), or all-cause mortality. Functional status was assessed with the Post-COVID-19 Functional Scale.<\/jats:p><jats:p>\n            Results\u2003In the primary analysis, 587 patients were included (age: 57 [Q1\u2013Q3: 45\u201368] years; 44% women). By 90-day follow-up, the main outcome occurred in 96 (33.1%) patients assigned to atorvastatin and 113 (38.0%) assigned to placebo (hazard ratio [HR]: 0.80, 95% confidence interval [CI]: 0.60\u20131.05, p\u2009=\u20090.11). Atorvastatin in patients who presented within 7 days of symptom onset was associated with reduced 90-day hazard for the main outcome (HR: 0.60, 95% CI: 0.42\u20130.86, p\n            interaction\u2009=\u20090.02). Atorvastatin use was associated with improved 90-day functional status, although the upper bound CI crossed 1.0 (ORordinal: 0.64, 95% CI: 0.41\u20131.01, p\u2009=\u20090.05).<\/jats:p><jats:p>\n            Conclusion\u2003Atorvastatin 20\u2009mg compared with placebo did not significantly reduce the 90-day composite of death, treatment with ECMO, or venous\/arterial thrombosis. However, the point estimates do not exclude a potential clinically meaningful treatment effect, especially among patients who presented within 7 days of symptom onset (NCT04486508).<\/jats:p>","DOI":"10.1055\/a-2059-4844","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T23:48:55Z","timestamp":1679442535000},"page":"723-733","source":"Crossref","is-referenced-by-count":8,"title":["Atorvastatin versus Placebo in ICU Patients with COVID-19: Ninety-day Results of the INSPIRATION-S Trial"],"prefix":"10.1055","volume":"123","clinical-trial-number":[{"clinical-trial-number":"nct04486508","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1839-3685","authenticated-orcid":false,"given":"Azita H.","family":"Talasaz","sequence":"additional","affiliation":[{"name":"Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran"},{"name":"Department of Pharmacotherapy and Outcome Sciences, Virginia Commonwealth University, Richmond, Virginia, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9602-0513","authenticated-orcid":false,"given":"Parham","family":"Sadeghipour","sequence":"additional","affiliation":[{"name":"Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran"},{"name":"Clinical Trial Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran"},{"name":"Cardiovascular Intervention Research Center, Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hooman","family":"Bakhshandeh","sequence":"additional","affiliation":[{"name":"Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran"},{"name":"Clinical Trial Center, Rajaie Cardiovascular, Medical, and 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Taghi","family":"Beigmohammadi","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keivan Gohari","family":"Moghadam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, Shariati Hospital, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somaye","family":"Rezaian","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Alborz University of Medicine Science, Karaj, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4344-8131","authenticated-orcid":false,"given":"Ali","family":"Dabbagh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, School of Medicine Anesthesiology Research Center Shahid Modarres Hospital, Shahid Beheshti University 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