Clinical Professor, School of Population & Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
Am J Med Sci. 2021 Apr;361(4):420-426. doi: 10.1016/j.amjms.2021.01.004. Epub 2021 Jan 9.
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.
随着 COVID-19 大流行导致的死亡率上升，我们可能忽略了免疫反应的一个关键方面。发热是这种猖獗感染的一个主要特征；然而，人们很少关注发热如何有助于我们战胜这种疾病。患者护理的三个关键方面——发热、液体和食物——可以协调一致，以克服 COVID-19 感染。动物和人体研究都表明，在病毒感染期间通过环境温度较低或使用退热剂抑制发热可能会增加发病率并延长病程。随着体温升高，抗利尿激素水平也会升高，导致无溶质水潴留——因此必须进行保守的液体管理。最后，发热抑制了胃肠道功能，因为能量被重新分配到免疫反应中，这凸显了需要与这些生理变化协同作用的必要性。有机会调查这种天然的感染屏障，我们不应错过。
