There is an increasing requirement for new therapeutic approaches to address lung inflammation caused by COVID-19. Recent evidence suggests that statins may reduce mortality in patients with respiratory infections. This study aimed to investigate the impact of statin use on COVID-19 outcomes among hospitalized patients at Ohud Hospital and King Salman Medical City (KSMC) in Madinah, Saudi Arabia. A retrospective cohort study was conducted, including 547 patients with confirmed COVID-19 diagnoses admitted between March 2020 and December 2022. Patients were classified into statin and non-statin users based on statin administration during hospitalization. Logistic regression analyses—including univariate, multivariate, and predictive stepwise models—were employed to assess associations between statin use and clinical factors. Among the 547 patients, 200 (36.5%) were prescribed statins upon admission. Statin users were predominantly men and older. The presence of low-density lipoprotein (LDL) levels ≥ 100 mg/dL, cardiovascular disease (CVD), and advanced age were identified as strong predictors of statin use, with odds ratios (ORs) of 11.1, 3.8, and 3.1, respectively. Furthermore, the odds of receiving statins were significantly higher in male patients, individuals with hypertension, those with HbA1c levels ≥ 8%, and patients with positive cultures and sensitivity results. Statin use was associated with an 18%% reduction in the risk of mortality, with an adjusted OR of 0.80 (95% CI, 0.30–2.32), and a 7% reduction in the risk of hospital stay > 10 days, although these findings did not reach statistical significance. Among patients with COVID-19, LDL ≥ 100 mg/dl, CVD, and patients older than 60 years were identified as strong predictors for statin prescription.