• Lorenzo Peluso, Federica Montanaro, Antonio Izzi, Alessandra Garufi, Narcisse Ndieugnou Djangang, Amandine Polain, Andrea Minini, Gouvea BogossianElisaEDepartment of Intensive Care Medicine, Erasme University Hospital, Brussels, Belgium., Filippo Annoni, Savino Spadaro, Jacques Creteur, and Fabio S Taccone.
• Department of Intensive Care Medicine, Erasme University Hospital, Brussels, Belgium - lorenzopeluso80@gmail.com.
• Minerva Anestesiol. 2021 Nov 1; 87 (11): 1217-1225.

BackgroundFever has been reported as a common symptom in COVID-19 patients. The aim of the study was to describe the characteristics of COVID-19 critically ill patients with fever and to assess if fever management had an impact on some physiologic variables.MethodsThis is a retrospective monocentric cohort analysis of critically ill COVID-19 patients admitted to the Department of Intensive Care Unit (ICU) of Erasme Hospital, Brussels, Belgium, between March 2020 and May 2020. Fever was defined as body temperature ≥38 °C during the ICU stay. We assessed the independent predictors of fever during ICU stay. We reported the clinical and physiological variables before and after the first treated episode of fever during the ICU stay.ResultsA total of 72 critically ill COVID-19 patients were admitted to the ICU over the study period and were all eligible for the final analysis; 53 (74%) of them developed fever, after a median of 4 [0-13] hours since ICU admission. In the multivariable analysis, male gender (OR 5.41 [C.I. 95% 1.34-21.92]; P=0.02) and low PaO2/FiO2 ratio (OR 0.99 [C.I. 95% 0.99-1.00]; P=0.04) were independently associated with fever. After the treatment of the first febrile episode, heart rate and respiratory rate significantly decreased together with an increase in PaO2 and SaO2.ConclusionsIn our study, male gender and severe impairment of oxygenation were independently associated with fever in critically ill COVID-19 patients. Fever treatment reduced heart rate and respiratory rate and improved systemic oxygenation.

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