Review
Version 1
Preserved in Portico This version is not peer-reviewed
The Role of Temperature in COVID-19 Disease Severity and Transmission Rates
Version 1
: Received: 4 May 2020 / Approved: 5 May 2020 / Online: 5 May 2020 (10:47:18 CEST)
Version 2 : Received: 5 September 2021 / Approved: 6 September 2021 / Online: 6 September 2021 (13:23:23 CEST)
Version 2 : Received: 5 September 2021 / Approved: 6 September 2021 / Online: 6 September 2021 (13:23:23 CEST)
A peer-reviewed article of this Preprint also exists.
Journal reference: J. Med. Virol. 2021, 93, 5358-5366
DOI: 10.1002/jmv.27042
Abstract
Air temperature and body temperature may influence COVID-19 disease severity and transmission rates. In vitro data indicate that SARS-CoV-2 loses infectivity at normal core body temperature (37°C); however, small reductions in temperature proximate to 37°C may result in substantially increased viral stability. If these results are representative of viral decay rates in vivo, then cooler temperatures in the body may enable more rapid viral growth. Breathing cool air—even as warm as 25°C—cools upper respiratory tract (URT) surfaces to several degrees below body temperature, and these lower temperatures may make the URT exceptionally conducive to SARS-CoV-2 replication. Increased URT viral load may enable more effective transmission. Additionally, because SARS-CoV-2 infection may frequently begin in the URT before spreading through the body, an increased rate of viral replication in the URT early in the disease course may result in more rapid progression of disease, potentially causing more severe adverse outcomes. Core body temperature may also be a factor in disease severity, as lower core body temperatures may enable more rapid viral growth. The significance of air temperature and body temperature to disease severity and transmission rates may inform preventative measures and post-exposure prophylaxis treatments for COVID-19.
Keywords
Covid; covid-19; sars-cov-2; temperature; heat; body temperature; air temperature; viral decay; viral stability; transmission; severity
Subject
LIFE SCIENCES, Virology
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Comments (1)
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Commenter: Erik Kulstad
Commenter's Conflict of Interests: Equity ownership of a company, Attune Medical, with technology in the patient temperature management space.
We've recently published a mathematical model of of patient warming, "The Use of Core Warming as a Treatment for Coronavirus Disease 2019 (COVID-19): an Initial Mathematical Model" (https://www.jca.org.br/jca/article/view/3382), and posted a planned clinical trial protocol, "Core warming of coronavirus disease 2019 (COVID-19) patients undergoing mechanical ventilation: protocol for a randomized controlled pilot study" (https://www.medrxiv.org/content/10.1101/2020.04.03.20052001v1).
Further clinical study is beginning, which we look forward to sharing once available.