Despite enhanced global vaccination programmes, new antimicrobials, and guidelines emphasising timeliness of treatment, mortality from pneumonia has remained relatively unchanged for six decades.1 The discovery that the severity of pneumonia is linked to an accompanying tide of systemic, pulmonary, and vascular inflammation represents an important advance in the understanding of this disease.2 Indeed, the acute lung injury, vascular dysfunction, and coagulopathy that often accompany pneumonia can lead to a self sustaining spiral of respiratory failure, sepsis, and death. Targeting the inflammation responsible for these events is a new but biologically plausible approach to treatment.3 In the linked retrospective cohort study (doi:10.1136/bmj.d1642), Douglas and colleagues examine this phenomenon by evaluating the impact of statins on mortality from pneumonia in a propensity matched cohort.4

Because statins inhibit hydroxymethyl glutaryl coenzyme A reductase they have important pleiotropic, anti-inflammatory properties. These effects have generated great interest in their role in non-lipid states. Evidence is growing of …