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https://doi.org/10.1093/ofid/ofaa375
Title: | Fever patterns, cytokine profiles, and outcomes in COVID-19 | Authors: | Ng, D.H.L. Choy, C.Y. Chan, Y.-H. Young, B.E. Fong, S.-W. Ng, L.F.P. Renia, L. Lye, D.C. Chia, P.Y. |
Keywords: | COVID-19 Cytokines Fever Prolonged Saddleback |
Issue Date: | 2020 | Publisher: | Oxford University Press | Citation: | Ng, D.H.L., Choy, C.Y., Chan, Y.-H., Young, B.E., Fong, S.-W., Ng, L.F.P., Renia, L., Lye, D.C., Chia, P.Y. (2020). Fever patterns, cytokine profiles, and outcomes in COVID-19. Open Forum Infectious Diseases 7 (9). ScholarBank@NUS Repository. https://doi.org/10.1093/ofid/ofaa375 | Rights: | Attribution-NonCommercial-NoDerivatives 4.0 International | Abstract: | Background. Prolonged fever is associated with adverse outcomes in dengue viral infection. Similar fever patterns are observed in COVID-19 with unclear significance. Methods. 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. Results. 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%; P < .01) and saddleback fever (14.3% vs 0.9%; P = .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%; P = .05). Patients with prolonged fever had higher induced protein.10 and lower interleukin-1? levels compared with those with saddleback fever at the early acute phase of disease. Conclusions. 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. © 2020 The Author(s). | Source Title: | Open Forum Infectious Diseases | URI: | https://scholarbank.nus.edu.sg/handle/10635/199713 | ISSN: | 2328-8957 | DOI: | 10.1093/ofid/ofaa375 | Rights: | Attribution-NonCommercial-NoDerivatives 4.0 International |
Appears in Collections: | Staff Publications Elements |
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