Belon Lucas, Skidmore Peter, Mehra Rohan, Walter Edward
Department of Intensive Care Medicine, Royal Surrey County Hospital, Guildford GU2 7XX, Surrey, United Kingdom.
Department of General Medicine, Royal Surrey County Hospital, Guildford GU2 7XX, Surrey, United Kingdom.
World J Clin Cases. 2021 Jan 16;9(2):296-307. doi: 10.12998/wjcc.v9.i2.296.
Acute infections, including those due to Coronaviridae and other viruses, often stimulate a febrile response. A mild fever appears to improve outcome; it appears to diminish viral replication by several mechanisms, including virion entry into host cells and genome transcription, and improving host defence mechanisms against the pathogen. However, a fever may also damage host cellular and tissue function and increase metabolic demands. At temperatures at the lower end of the febrile range, the benefit of the fever appears to outweigh the detrimental effects. However, at higher temperatures, the outcome worsens, suggesting that the disadvantages of fever on the host predominate. A non-infective fever is associated with a worse outcome at lower temperatures, suggesting that hyperthermia carries less benefit in the absence of infection. This review discusses the risks and benefits of a fever on the host response, focusing on the effects of a fever on viral replication and host response, and the detrimental effect on the host.
急性感染，包括由冠状病毒科和其他病毒引起的感染，常常会引发发热反应。低热似乎会改善病情；它似乎通过多种机制减少病毒复制，这些机制包括病毒粒子进入宿主细胞和基因组转录，以及改善宿主针对病原体的防御机制。然而，发热也可能损害宿主细胞和组织功能，并增加代谢需求。在发热范围较低端的温度下，发热的益处似乎超过了有害影响。然而，在较高温度下，病情会恶化，这表明发热对宿主的不利影响占主导。非感染性发热在较低温度下与更差的病情相关，这表明在没有感染的情况下，体温过高带来的益处较少。本综述讨论了发热对宿主反应的风险和益处，重点关注发热对病毒复制和宿主反应的影响，以及对宿主的有害影响。
