Is statin use associated with reduced mortality after pneumonia? A systematic review and meta-analysis

Objective: The objective of this study was to perform a systematic review and meta-analysis of the effects of statins on mortality following pneumonia.

Methods: We searched MEDLINE, EMBASE, BIOSIS, Cochrane CENTRAL Register of Controlled Trials, Cambridge Scientific Abstracts, BIOSIS, and Scopus. Studies were included if they involved: participants ≥18 years of age; patients with community-acquired pneumonia; current statin users; and reported overall or adjusted mortality after pneumonia.

Results: Of 491 citations identified, 13 studies involving 254,950 patients met eligibility criteria. Pooled unadjusted data showed that statin use was associated with lower mortality after pneumonia (odds ratio [OR] 0.62, 95% confidence interval [CI], 0.54-0.71). Pooling of adjusted data also showed reduced mortality after pneumonia (OR 0.66, 95% CI, 0.55-0.79). However, this effect was attenuated in subgroup analysis by confounders and in prospective studies.

Conclusions: Although statin use is associated with decreased mortality after pneumonia, this effect weakens in important subgroups. Only a randomized controlled study can fully explore the link between statins and pneumonia mortality.