Fever: Could A Cardinal Sign of COVID-19 Infection Reduce Mortality?

Am J Med Sci. 2021 Apr;361(4):420-426. doi: 10.1016/j.amjms.2021.01.004. Epub 2021 Jan 9.

Abstract

With mortality rising from the COVID-19 pandemic, we may be overlooking a key aspect of the immunological response. Fever is a cardinal sign of this rampant infection; however, little attention has been paid towards how a fever may work in our favor in overcoming this disease. Three key aspects of patient care - fever, fluid, and food - can be harmonized to overcome COVID-19 infection. Both animal and human studies have demonstrated that fever suppression during viral infections, either through low ambient temperatures or antipyretic use, may increase morbidity and prolong the illness. As fever rises, so do antidiuretic hormone levels, leading to solute-free water retention - making conservative fluid management essential. Finally, fever inhibits gastrointestinal function as energy is reallocated to the immunological response, underscoring the need to work in concert with these physiological changes. An opportunity awaits to investigate this natural barrier to infection, let us not pass it by.

Keywords: Antipyretics; COVID-19; Fever; Fluid management; Nutrition.

Publication types

  • Review

MeSH terms

  • Antipyretics / therapeutic use
  • COVID-19 / mortality*
  • COVID-19 / physiopathology
  • COVID-19 / virology
  • Fever / drug therapy
  • Fever / physiopathology*
  • Humans
  • SARS-CoV-2 / isolation & purification

Substances

  • Antipyretics