Fever increases heart rate and respiratory rate; a prospective observational study of acutely admitted medical patients

Jensen, Maria Maj; Kellett, John; Hallas, Peter; Brabrand, Mikkel

doi:10.52964/amja.0766

Cited by 14 publications

(10 citation statements)

References 6 publications

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“…In general, heart rate has a specific relationship with body temperature. As body temperature increases, heart rate will also increase [ 18 ]. Recent study has shown that in acutely admitted patients, the heart rate will increase by 6.4 beats/min when body temperature increases 1 °C than the normal limit after adjusting for age, oxygen saturation, and mean blood pressure [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

“…As body temperature increases, heart rate will also increase [ 18 ]. Recent study has shown that in acutely admitted patients, the heart rate will increase by 6.4 beats/min when body temperature increases 1 °C than the normal limit after adjusting for age, oxygen saturation, and mean blood pressure [ 18 ]. As such, the heart rates of Case 1, Case 2, and Case 3 should have increased by 8 beats/min, 17 beats/min, and 13 beats/min, respectively, as their temperature increased.…”

Section: Discussionmentioning

confidence: 99%

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Decreased Heart Rate Variability in COVID-19

Yin

Wang

et al. 2022

Intensive Care Res

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Purpose Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which primarily infects the lower airways and binds to angiotensin-converting enzyme 2 (ACE2) on alveolar epithelial cells. ACE2 is widely expressed not only in the lungs but also in the cardiovascular system. Therefore, SARS-CoV-2 can also damage the myocardium. This report aimed to highlight decreased heart rate variability (HRV) and cardiac injury caused by SARS-CoV-2. Materials and Methods We evaluated three COVID-19 patients who died. Patients’ data were collected from electronic medical records. We collected patient’s information, including baseline information, lab results, body temperature, heart rate (HR), clinical outcome and other related data. We calculated the HRV and the difference between the expected and actual heart rate changes as the body temperature increased. Results As of March 14, 2020, 3 (2.2%) of 136 patients with COVID-19 in Tianjin died in the early stage of the COVID-19 epidemic. The immediate cause of death for Case 1, Case 2, and Case 3 was cardiogenic shock, cardiac arrest and cardiac arrest, respectively. The HRV were substantially decreased in the whole course of all three cases. The actual increases in heart rate were 5 beats/min, 13 beats/min, and 4 beats/min, respectively, less than expected as their temperature increased. Troponin I and Creatine Kinase MB isoenzyme (CK-MB) were substantially increased only in Case 3, for whom the diagnosis of virus-related cardiac injury could not be made until day 7. In all three cases, decreased in HRV and HR changes occurred earlier than increases in cardiac biomarkers (e.g., troponin I and CK-MB). Conclusions In conclusion, COVID-19 could affect HRV and counteract tachycardia in response to increases in body temperature. The decreases of HRV and HR changes happened earlier than the increases of myocardial markers (troponin I and CK-MB). It suggested the decreases of HRV and HR changes might help predict cardiac injury earlier than myocardial markers in COVID-19, thus its early identification might help improve patient prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Decreased Heart Rate Variability in COVID-19

Yin

Wang

et al. 2022

Intensive Care Res

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“…Similarly, lymphopenia in the present case might reflect the dysregulated cellular immune response in measles. In addition, to explain why the present case appeared tachypneic at triage, but maintained normal oxygen saturation without supplemental oxygenation, we presumed that both tachypnea and tachycardia were due to a normal compensatory physiological response to the persistent elevated body temperature, despite the lack of chest x-ray to clearly exclude the presence of lung infiltrates [68].…”

Section: Discussionmentioning

confidence: 87%

First Disease and the Great Imitator: A Diagnostic Dilemma with Ancient Maladies

Imad¹,

Lakanavisid²,

Pisutsan³

et al. 2022

Preprint

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Fever and rash as manifestations of infection by microorganisms are collectively known as febrile exanthem. Viruses are more frequently associated with febrile exanthema, and often these symptoms are thus impetuously termed viral exanthem. However, bacteria represent a frequently overlooked infectious etiology causing rash in humans. In addition, certain microbes may exhibit pathognomonic features that erupt during illness and facilitate clinical diagnosis. Conversely, coinfections often obscure the clinical characteristics of the primary disease and further challenge clinicians attempting to reach a diagnosis. We retrospectively looked at de-identified clinical data of a patient who presented to the Hospital for Tropical Diseases in Bangkok in July 2019 with complaints of fever and rash. The case involved a 35-year-old who presented with a 3-day history of fever, respiratory symptoms, myalgia, conjunctivitis, diarrhea, and a generalized maculopapular rash. On examination, the patient was febrile, tachycardic, and tachypneic, with a mean arterial pressure of 95 mmHg. A differential white blood cell count showed: leukocytes, 5800/µL; neutrophils, 4408/µL; lymphocytes, 406/µL; and platelets, 155,000/µL. Striking findings involving the integumentary system included Koplik’s spots and generalized maculopapular rash. Further serology revealed positive immunoglobulin (Ig)M and IgG for both measles and rubella virus, including reactive serology for Treponema pallidum. Here we describe the clinical course and management of this patient.

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“…Similarly, lymphopenia in the present case might reflect the dysregulated cellular immune response in measles. In addition, to explain why the present case appeared tachypneic at triage but maintained normal oxygen saturation without supplemental oxygenation, we presumed that both tachypnea and tachycardia were due to a normal compensatory physiological response to the persistent elevated body temperature, despite the lack of a chest X-ray to clearly exclude the presence of lung infiltrates [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash

et al. 2022

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Fever and rash as manifestations of infection by microorganisms are collectively known as febrile exanthem. Since viruses are more frequently associated with fever and rash, these symptoms are thus impetuously termed viral exanthem. However, bacteria represent a frequently overlooked infectious etiology causing rash in humans. In addition, certain microbes may exhibit pathognomonic features that erupt during illness and facilitate clinical diagnosis. Conversely, coinfections often obscure the clinical characteristics of the primary disease and further challenge clinicians attempting to reach a diagnosis. We retrospectively looked at de-identified clinical data of a patient who presented to the Hospital for Tropical Diseases in Bangkok in July 2019 with complaints of fever and rash. The case involved a 35-year-old who presented with a 3-day history of fever, respiratory symptoms, myalgia, conjunctivitis, diarrhea, and a generalized maculopapular rash. On examination, the patient was febrile, tachycardic, and tachypneic, with a mean arterial pressure of 95 mmHg. A differential white blood cell count showed: leukocytes, 5800/µL; neutrophils, 4408/µL; lymphocytes, 406/µL; and platelets, 155,000/µL. Striking findings involving the integumentary system included Koplik’s spots and generalized maculopapular rash. Further serology revealed positive immunoglobulin (Ig)M and IgG for both measles and rubella virus, including reactive serology for Treponema pallidum. Here we describe the clinical course and management of this patient.

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Fever increases heart rate and respiratory rate; a prospective observational study of acutely admitted medical patients

Cited by 14 publications

References 6 publications

Decreased Heart Rate Variability in COVID-19

Decreased Heart Rate Variability in COVID-19

First Disease and the Great Imitator: A Diagnostic Dilemma with Ancient Maladies

A Case Report of Secondary Syphilis Co-Infected with Measles: A Diagnostic Dilemma with Fever and Rash

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