Vandermeer ML. J Infect Dis.
The use of statin therapy was associated with a reduced
risk for mortality among patients hospitalized with influenza during the
2007-2008 influenza season, according to new findings published in the
Journal of Infectious Diseases.
Seventy-six percent of patients reported use of statins
before and during hospitalization; were more likely to be older white males;
have cardiovascular, metabolic, renal and chronic lung disease; and to have
received influenza vaccination.
“Statins are a promising area of study as an
adjunct to vaccine and antivirals in preventing severe complications from
influenza,” Ann R. Thomas, MD, MPH,of the Oregon Public Health
Division, told Infectious Disease News. “Part of their appeal is
that they could be used when the available vaccine is not well matched to the
circulating strain of influenza, or if antiviral medications are either not
available or resistant.”
Ann R. Thomas, MD, MPH
The researchers pooled data from the CDC’s Emerging
Infections Program influenza hospitalization surveillance system, which
included 59 counties across 10 states. Researchers assessed the association
between statin use and influenza-associated mortality among adults hospitalized
during the 2007-2008 influenza season.
Of 3,043 patients hospitalized with influenza (median
age, 70.4 years; 56% women), 33.3% reported use of statins and 5% died within
30 days of their influenza test.
After adjusting for age, race, history of influenza
vaccination, antiviral use and underlying conditions, administration of statins
before or during hospitalization was associated with a protective odds for
mortality (OR=0.59; 95% CI, 0.38-0.92).
“Our findings need to be confirmed in randomized
clinical trials before we would recommend that statins become standard of care
for treatment of severe cases of influenza,” Thomas said.
Disclosure: This work was funded by the Emerging
Infections Program Cooperative Agreement between the 10 study sites and the
William Schaffner, MD
This is a very intriguing study indicating that, in this large
population, patients who did not receive statins were almost twice as likely to
die of influenza as those who did receive statins. Some of the advantages of
this study are that it was a large, rigorously performed study that actually
took into account many potential variables, including age, race, cardiovascular
disease, chronic lung disease, renal disease, the receipt of influenza vaccine
and the initiation of antiviral therapy within 48 hours of admission to the
hospital. This study confirms and extends some other smaller, prior studies and
suggests that statins do indeed offer some promise for the treatment of
influenza, certainly among hospitalized patients as an adjunct to antiviral
therapy. In those circumstances where the circulating virus may not have been
very well matched to the vaccine, when the influenza virus strains are not
susceptible to antiviral medication, or when vaccine is in short supply; these
all may be circumstances where physicians may consider statins. It also, I
hope, will promote further prospective studies because one of the limitations
of this study is that the dose of statins and the duration of administration
could not be taken into account.
– William Schaffner, MD
Infectious Disease News Editorial Board member
President, National Foundation for Infectious Diseases
Disclosure: Dr. Schaffner reports no relevant