Ng, Deborah HL, Choy, Chiaw Yee, Chan, Yi-Hao, Young, Barnaby E, Fong, Siew-Wai, Ng, Lisa FP 
ORCID: 0000-0003-4071-5222, Renia, Laurent, Lye, David C and Chia, Po Ying
(2020)
Fever Patterns, Cytokine Profiles, and Outcomes in COVID-19.
OPEN FORUM INFECTIOUS DISEASES, 7 (9).
ofaa375-.
Abstract
<h4>Background</h4>Prolonged fever is associated with adverse outcomes in dengue viral infection. Similar fever patterns are observed in COVID-19 with unclear significance.<h4>Methods</h4>We conducted a hospital-based case-control study of patients admitted for COVID-19 with prolonged fever (fever >7 days) and saddleback fever (recurrence of fever, lasting <24 hours, after defervescence beyond day 7 of illness). Fever was defined as a temperature of ≥38.0°C. Cytokines were determined with multiplex microbead-based immunoassay for a subgroup of patients. Adverse outcomes were hypoxia, intensive care unit (ICU) admission, mechanical ventilation, and mortality.<h4>Results</h4>A total of 142 patients were included in the study; 12.7% (18/142) of cases had prolonged fever, and 9.9% (14/142) had saddleback fever. Those with prolonged fever had a median duration of fever (interquartile range [IQR]) of 10 (9-11) days for prolonged fever cases, while fever recurred at a median (IQR) of 10 (8-12) days for those with saddleback fever. Both prolonged (27.8% vs 0.9%; <i>P</i> < .01) and saddleback fever (14.3% vs 0.9%; <i>P</i> = .03) were associated with hypoxia compared with controls. Cases with prolonged fever were also more likely to require ICU admission compared with controls (11.1% vs 0.9%; <i>P</i> = .05). Patients with prolonged fever had higher induced protein-10 and lower interleukin-1α levels compared with those with saddleback fever at the early acute phase of disease.<h4>Conclusions</h4>Prolonged fever beyond 7 days from onset of illness can identify patients who may be at risk of adverse outcomes from COVID-19. Patients with saddleback fever appeared to have good outcomes regardless of the fever.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | COVID-19, cytokines, fever, prolonged, saddleback |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Infection, Veterinary and Ecological Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 24 May 2021 09:28 |
| Last Modified: | 26 Jan 2023 02:52 |
| DOI: | 10.1093/ofid/ofaa375 |
| Open Access URL: | https://doi.org/10.1093/ofid/ofaa375 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3123854 |
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