Bogovic et al.

Impact of pre-existing treatment with statins on the course and outcome of tick-borne encephalitis. PLoS ONE 13 (10): e0204773. https://doi.org/10.1371/journal.pone.0204773

Statins (3-hydroxy-3-methylglutaryl-CoA reductase inhibitors) are widely used for lipid-lowering medications and to reduce cardiovascular disease and mortality in those who are at risk of cardiovascular disease. There are some reports that statins have anti-inflammatory and antimicrobial/antiviral activity, and the impact of statins on infectious diseases is controversial. A study has been carried out in Slovenia from 2007 to 2012 with 700 adult TBE patients of whom 77 (11%) were being treated with statins and 410 patients of whom 53 (13%) were receiving statins, respectively. Detailed analyses of the course and severity of illness were done including a final follow-up visit in 2014, 2 to 7 years after diagnosis of TBE. The authors could not find that pre-existing use of statins affected the severity of the acute illness nor the long-term outcome of TBE. Serum and CSF samples were available on 79 patients (of whom 13 were receiving statins) for cytokine and chemokine determinations. No significant differences between patients receiving statins and those not treated with statins were found in CSF or serum levels for any of 24 cytokines or chemokines measured. The use of statins was associated with a more severe illness; however, this estimated effect was lost in a multivariable model. Receiving statins was also not associated with a favorable outcome defined by the absence of post-encephalitis syndrome at six or 12 months or two to seven years after acute illness. Thus, this observational study could not prove that the pre-existing use of statins has an impact of the severity of TBE or on the long-term outcome of TBE in Slovenian patients infected by the European subtype of TBE virus.

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