Impact of Long-Term Statin Therapy on Incidence and Severity of Community-Acquired Pneumonia: A Real-World Data Analysis

Objectives: This study aims to evaluate the impact of chronic statin therapy on the incidence of community-acquired pneumonia (CAP) and the rate of intensive care unit (ICU) admissions associated with CAP. Methods: Two population-based dynamic cohorts, consisting of individuals exposed and unexposed to statins, were followed from 2010 to 2019. Participants were older than 60 years, with frail patients excluded. The primary outcomes were the incidence of CAP and ICU admissions due to CAP, serving as a proxy for complicated cases. The exposed cohort included new statin users with at least two pharmacy invoices within 90 days of the recruitment period. Adjusted risk ratios (aRRs) for CAP incidence and CAP-associated ICU admissions were calculated using Poisson regression. Results: This study analyzed a sample of 639,564 individuals, evenly divided into exposed (319,782) and unexposed (319,782) groups, with a mean age of 71 years (standard deviation of 8 years) and 57% women. New statin users had a higher incidence of CAP [42.1 (95% confidence interval: 41.9-42.2) vs. 36.6 (36.5-36.8) per 1000 person-years] and ICU admissions [11.5 (11.5-11.6) vs. 10.1 (10.0-10.1) per 1000 person-years] compared to non-users. The adjusted analysis indicated that statin treatment reduced CAP risk by 6% [aRR: 0.94 (0.91-0.96)] and ICU admission by 7% [aRR: 0.93 (0.88-0.98)]. Conclusions: Prior statin therapy was associated with a clinically significant reduction in the incidence of CAP and ICU admissions due to CAP, despite the greater vulnerability of new users at the start of treatment compared to non-users.