Hyperpyrexia in patients with COVID‐19

Coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) is a global health emergency, in which its effective treatment and prevention remain obscured. Hyperpyrexia is an elevation of body temperature above 106.7°F (41.5°C) due to an abnormally increased hypothalamic‐thermoregulatory set. The pathophysiology, impact, and outcomes of hyperpyrexia in patients with COVID‐19 have not yet been studied. Herein, we present clinical features and outcomes of six patients with COVID‐19 who had developed hyperpyrexia during hospitalization. All patients expired shortly after the onset of hyperpyrexia. Hyperpyrexia seems to adversely impact the outcomes and mortality in patients with COVID‐19. The underlying mechanisms of developing hyperpyrexia in COVID‐19 are mysterious. We propose it may be caused by SARS‐CoV‐2‐related brain injury, exuberant immune response, and thrombus formation. More research is needed to verify our results. Understanding the association between hyperpyrexia and SARS‐CoV‐2 will help to elucidate the COVID‐19 pathogenesis, which is mandatory for developing effective treatment strategies. Highlights Hyperpyrexia is a negative prognostic factor for COVID‐19. The pathogenesis of hyperpyrexia in COVID‐19 is undetermined but it may be caused by SARS‐CoV‐2‐related brain injury, exuberant host immune response, and thrombus formation.