Infectious Disease

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 CDC.

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 financial disclosures.

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