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Review
. 2022 Nov 7;18(6):1513-1524.
doi: 10.5114/aoms/149633. eCollection 2022.

The effect of statins on the prevalence and mortality of influenza virus infection: a systematic review and meta-analysis

Amir Vahedian-Azimi  1 , Massimo R Mannarino  2 , Sajad Shojaie  3 , Farshid Rahimibashar  4 , Hadi Esmaeili Gouvarchin Galeh  5 , Maciej Banach  6   7 , Vanessa Bianconi  2 , Matteo Pirro  2 , Amirhossein Sahebkar  8   9   10   11
Affiliations
Review

The effect of statins on the prevalence and mortality of influenza virus infection: a systematic review and meta-analysis

Amir Vahedian-Azimi et al. Arch Med Sci. .

Abstract

Introduction: Influenza virus infection is associated with high morbidity and mortality, and so additional therapeutic strategies to reduce the burden for healthcare systems are needed. Statins, by virtue of their anti-inflammatory and immunomodulatory effects, have been hypothesized as capable of influencing the host's response against the influenza virus. The aim of this meta-analysis was to assess the effect of ongoing statin treatment on susceptibility to influenza virus infection and on influenza-associated mortality.

Material and methods: Studies investigating the impact of statin treatment on influenza prevalence and mortality were searched for in the PubMed-Medline, Scopus, ISI Web of Knowledge, Embase, Proquest, OVID, EBSCO, and CINAHL databases (up to 8 November 2021). Fixed- and random-effects models and the generic inverse variance method were used for quantitative data synthesis.

Results: In the meta-analysis of 14 arms of 2 eligible studies, including 14,997 flu-vaccinated and unvaccinated patients, treatment with statins was associated with a reduction of influenza virus prevalence (odds ratio (OR) = 0.85, 95% confidence interval (CI): 0.73-0.99; p = 0.040). No significant effect of statins on the susceptibility to influenza infection was observed in the distinct communities of either vaccinated or unvaccinated subjects. Among 9 arms of 6 eligible studies, including 87,204 patients, the use of statins among patients with influenza was associated with a reduced mortality (OR = 0.68, 95% CI: 0.56, 0.82; p < 0.001). This result was confirmed for both 30-day mortality since influenza infection diagnosis (OR = 0.61, 95% CI: 0.47, 0.80; p <0.001) and for up to 90-day mortality (OR = 0.74, 95% CI: 0.55, 1.00; p = 0.042).

Conclusions: Reduced influenza prevalence and increased survival from influenza infection was observed in patients on ongoing statin treatment. Further research is needed to define the possible role of statins as adjunctive therapy in patients with influenza infection.

Keywords: immunomodulatory effects; influenza; mortality; prevalence; statins; vaccine.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study selection process
Figure 2
Figure 2
Forrest plot for odds ratio of the use of statins and influenza outcome analysis in the community of vaccine and non-vaccine recipients
Figure 3
Figure 3
Radial plot for heterogeneity of the use of statins and influenza outcome analysis in the community of vaccine and non-vaccine recipients
Figure 4
Figure 4
Funnel plot for verification of publication bias of the use of statins and influenza outcome analysis in the community of vaccine and non-vaccine recipients
Figure 5
Figure 5
Forrest plot for odds ratio of the use of statins and influenza outcome analysis in the community of vaccine recipients
Figure 6
Figure 6
Radial plot for heterogeneity of the use of statins and influenza outcome analysis in the community of vaccine recipients
Figure 7
Figure 7
Funnel plot for verification of publication bias of the use of statins and influenza outcome analysis in the community of vaccine recipients
Figure 8
Figure 8
Forrest plot for odds ratio of the use of statins and influenza outcome analysis in the community of non-vaccine recipients
Figure 9
Figure 9
Radial plot for heterogeneity of the use of statins and influenza outcome analysis in the community of non-vaccine recipients
Figure 10
Figure 10
Funnel plot for verification of publication bias of the use of statins and influenza outcome analysis in the community of non-vaccine recipients
Figure 11
Figure 11
Forrest plot for odds ratio of mortality event due to using statins in the community of influenza patients
Figure 12
Figure 12
Radial plot for heterogeneity of mortality event due to using statins in the community of influenza patients
Figure 13
Figure 13
Funnel plot for verification of publication bias of mortality event due to using statins in the community of influenza patients
Figure 14
Figure 14
Summary
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