The onset of fever in a COVID-19 situation is a defence mechanism against the infection. Its absence in other respiratory infections is a bad sign. Given that there is no specific treatment against the virus, one must wonder whether attempting to lower the fever as soon as it appears is preferable to letting the body’s natural defence mechanisms take over.

The younger an adult with healthy heart, lungs, brain, and kidneys the better he can tolerate a high temperature.

We could consider lowering it down as needed without totally eradicating it.

Fluids and minerals loss could be compensated by taking tomato juice or soup; both of which have good mineral contents. As water loss is the main factor in weight loss, it is advisable to step on the scale and aim at maintaining a stable weight.

Pre-existing health conditions in some individuals may call for rapid intervention in lowering their temperature (Figure1). In such cases it is preferable to use ice (head, neck, armpits, groins), a fresh bath or yet, acetaminophen (like atasol, tylenol).

Early in the pandemic, there were calls to specifically, avoid nonsteroidal anti-inflammatory drugs NSAID (advil, motrin, aspirine, anaprox, naprosyn etc.) to lower the temperature if possible but this has been called in question and there is no clear guidance to be provided at this moment. NSAID are known to potentially cause kidney complications and that it could be an issue among the most severe cases. Those taking chronically aspirine (salicylate) or NSAID for cardiovascular prevention, arthritis, chronic pain, migraine or other chronic conditions should not discontinue their medication. The World Health Organization declared that there was no evidence of increased mortality among those COVID-19 who took some NSAID (Giollo A, Adami G, Gatti D, et al Coronavirus disease 19 (Covid-19) and non-steroidal anti-inflammatory drugs (NSAID) Annals of the Rheumatic Diseases Published Online First: 22 April 2020. doi: 10.1136/annrheumdis-2020-217598).

Replacement of fluids and minerals loss because of fever must be done cautiously in individuals suffering from advanced stages of cardiac or kidney disease.

To know your weight when you are in your best of shape and to be able to maintain it rather constant is of paramount importance as well as being aware of your existing shortness of breath and swelling of your feet. Keeping the right balance as we do not want to over compensate for loss of fluids and minerals and end up with shortness of breath and swelling of ankles and feet; yet at the same time, we do not want to be dehydrated and dizzy.

If you experience fever and suspect having COVID- 19 you must contact public health at 1 877 644-4545 and state your medical condition. Get in contact with your family doctor or your specialists as needed.

page 08