A preliminary study in the Journal of Infectious Diseases finds that patients hospitalized with influenza were less likely to die if they were taking a statin, compared with their peers who weren't taking one of the drugs. The effect held even after adjusting for heart disease.
But it's far too soon to consider adding statins to the existing anti-flu armamentarium, the authors stated.
"At this point, statins should not become the standard of care for people hospitalized with the flu," cautioned study co-author Dr. Ann Thomas, a public health physician with the Oregon Public Health Division in Portland. "We would like to see more studies, [and] I think it would be worthwhile to do these studies."
Right now, preventive vaccinations and antiviral medications are the best weapons against this wily foe, but both stop far short of perfection.
Statins have piqued the interest of virologists and others because they may have anti-inflammatory properties that might mitigate the damage from the influenza virus.
"There have been a couple of studies that have found an apparent association between statins and improved mortality in patients who've had sepsis [blood infections], who've had community-acquired pneumonia," said Dr. Bruce Hirsch, an attending physician in infectious diseases at North Shore University Hospital in Manhasset, NY.
This is the first observational study to investigate a possible relationship between statins and deaths from the flu.
The authors reviewed chart records on more than 3,000 patients hospitalized with laboratory-confirmed influenza in 10 states during the 2007-2008 flu season.
Patients on statins were 41 percent less likely to die, the study found, even after adjusting for age, the presence of heart, lung and/or kidney disease, whether or not they had had a flu shot, or whether or not they had received antiviral medications such as Tamiflu (oseltamivir).
But the study also suffers from several limitations, as the authors themselves acknowledged.
Perhaps most importantly, the authors do not know if patients taking statins were already healthier than people not taking statins.
"The big question at baseline was were the people on statins healthier than those not on statins and did that account for why they were less likely to die?" Thomas said. "That's difficult to answer."
"There's no question that these observations are striking in terms of death from influenza but they can't say why," said Dr. Len Horovitz, a pulmonary specialist with Lenox Hill Hospital in New York City. "Why did these people start statins? Were they cardiac patients? Did they think it was a good idea because their cholesterol looked lousy?"
A randomized controlled trial could provide some of these answers but only two have been registered, one of which is terminated and the other of which is no longer recruiting.
This study was sponsored by the U.S. Centers for Disease Control and Prevention's Emerging Infections Program, which usually only does observational studies, Thomas said.
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