Doctors Puzzled by Report Claiming Two-Thirds of 'Seriously Ill' COVID-19 Patients Didn't Have Fever

A high fever is considered one of the symptoms of COVID-19, the respiratory illness caused the novel coronavirus. However, a new study of New York patients published in the Journal of the American Medical Association revealed that two-thirds of the seriously ill patients did not have a fever. The study also found several commonalities among the previous medical conditions the patients had.

The study was published on Wednesday and studied 5,700 patients hospitalized in New York City, Long Island and Westchester County at hospitals in the Northwell Health system between March 1 and April 4. The most common conditions among the patients were hypertension, obesity and diabetes. Just over half of the patients suffered from hypertension, and 41.7% suffered from obesity. Just over 33% percent had diabetes.

"The most surprising finding to me was that two-thirds of the patients who were seriously ill with an active infection did not have a fever," senior researcher Karina Davidson, M.D., told KTRK-TV. Fever is usually the first symptom doctors check for, but Davidson said some of the sickest patients in the study did not exhibit a high fever. "This is a puzzling infection," she added. "Different people have different symptoms, some of them mild, some of those severe."

Davidson noted that studies of COVID-19 are showing it is more that a lung disease. "It is going to have not just short-term effects that are deleterious on many target organs, but we may be looking at an infection that has long-term consequences," she explained.

Of the patients included in the study, 553 died. As of April 4, 1,151 patients needed mechanical ventilation, and 282 of those died, while 831 were still in the hospital. Men were more likely to die than women in every age group studied. More patients with diabetes developed acute kidney injury compared to those without.

A fever higher than the typical 98.6 degrees Fahrenheit is one of the symptoms of the coronavirus, but experts told CNN patients should not be fixated on a specific number. A person is not usually considered feverish until their temperature hits 100 degrees Fahrenheit.

"There are many misconceptions about fever," Dr. John Williams, chief of the division of pediatric infectious diseases at the University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, explained to CNN. "We all actually go up and down quite a bit during the day as much as half of a degree or a degree," he said, adding that for many, "99.0 degrees or 99.5 degrees Fahrenheit is not a fever."


Infectious disease expert Dr. William Schaffner, a professor of preventative medicine and infectious disease at Vanderbilt University School of Medicine in Nashville, also explained that taking your temperature early in the morning is not a good idea. "Our temperature is not the same during the day. If you take it at eight o'clock in the morning, it may be normal," Schaffner said. "One of the most common presentations of fever is that your temperature goes up in the late afternoon and early evening. It's a common way that viruses produce fever."

Other symptoms of COVID-19 include shortness of breath, dry cough, chills and body aches, sudden confusion, pink eye, digestive problems, loss of smell and taste, fatigue and headache, sore throat or congestion. Symptoms can appear between two to 14 days after exposure to the coronavirus, according to the Centers for Disease Control and Prevention.