Age modifies both the maximal temperature and inflammatory response in patients with SARS-CoV-2 infection

Abstract

Objective: To determine the maximal response of the temperature and inflammatory response to SARS-CoV-2 infection and how these are modified by age.

Methods: Participants were patients admitted to hospital with SARS-CoV-2 infection. For each participant, the maximal temperature and serum C-reactive protein (CRP) were identified and stratified by age. In a secondary analysis, these were compared in patients treated before and after dexamethasone.

Results: Mean maximal temperature varied by age (p<0.001; ANOVA) with the highest mean maximal temperature of 37.3°C observed in patients aged 30-49 years and decreasing maximal mean temperatures in the older age groups, with the lowest measure of 36.8°C observed in individuals aged 90-99 years. The mean maximal serum CRP also varied across age groups (p<0.001; ANOVA) and increased with age across all age categories from 34.5 mg/dL (95% confidence interval (CI) 22.0-47.0) for individuals aged 20-29 years to 77.6 mg/dL (95% CI 72.0-83.2) in those aged 80-89 years. After dexamethasone became standard treatment for COVID-19 pneumonia, mean maximal CRP decreased by 17 mg/dL (95% CI -22 to -11).

Conclusion: Age modifies both maximal temperature and systemic inflammatory response in patients with SARS-CoV-2 infection.

Keywords: COVID-19; age; infection; inflammation; temperature.

Fig 1.

Distributions of patients by 10-year age bands, in maximum per patient. a) Temperature. b) C-reactive protein. c) Systolic blood pressure. d) Diastolic blood pressure. e) Heart rate. f) Neutrophils.