ReviewEvolution, medicine, and public health2021
Let fever do its job: The meaning of fever in the pandemic era.
Review in Evolution, medicine, and public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 81 citations in OpenAlex.
- Clinical Practice Guideline: The Outpatient Management of Fever in Children and Adolescents.Deutsches Arzteblatt international · 2026Guideline
- Long-term health effects of antipyretic drug use in the aging population: a systematic review.Journal of medicine and life · 2024Pooled it
- The carotid body in sepsis: From homeostatic defense to immunometabolic dysregulation.Brain, behavior, & immunity - health · 2026Review
- The poikilothermic hypothesis of sepsis.Critical care (London, England) · 2026Review
- Reframing myofascial pain syndrome: pathological disorder or adaptive protective response?Therapeutic advances in musculoskeletal disease · 2026Review
- The cycle of infectious fever - how it affects bacterial infections.Frontiers in cellular and infection microbiology · 2026Review
- Fever Inspiration: Precision Engineering for Safe and Systemic Immunotherapy.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
- Integrative evidence-informed management of feverish illnesses in childhood-outcomes of the public FeverFriend prospective app registry.Frontiers in public health · 2026Article
- Association Between Pre-Admission 48-Hour Fever Burden and Outcomes in Pediatric Mycoplasma Pneumoniae Infection.Mediterranean journal of hematology and infectious diseases · 2026Article
- Avian-origin influenza A viruses tolerate elevated pyrexic temperatures in mammals.Science (New York, N.Y.) · 2025Article
- Endotoxin's Impact on Organism: From Immune Activation to Tolerance and Beyond.Journal of clinical medicine · 2025Review
- Fevogrit, a polyherbal medicine, mitigates endotoxin (lipopolysaccharide)-induced fever in Wistar rats by regulating pro-inflammatory cytokine levels.Animal models and experimental medicine · 2025Article
- The Elephant and the Spandrel.Evolution, medicine, and public health · 2025Article
- Changes in parental knowledge and concerns regarding pediatric fever from 2017 to 2024: repeated cross-sectional surveys on the association of a smartphone application.Frontiers in public health · 2025Article
- A pilot observational study of the association of 24-hour mortality with the subjective assessment of the forearm skin temperature and moisture compared to other bedside indicators of illness severity.Resuscitation plus · 2025Article
- Beyond nutritional immunity: immune-stressing challenges basic paradigms of immunometabolism and immunology.Frontiers in nutrition · 2025Review
- Thermoregulation and survival during sepsis: insights from the cecal ligation and puncture experimental model.Intensive care medicine experimental · 2024Article
- Association between Acute and Chronic Inflammatory States: A Case-Control Study.Homeopathy : the journal of the Faculty of Homeopathy · 2024Article
- The role of microglia in 67NR mammary tumor-induced suppression of brain responses to immune challenges in female mice.Journal of neurochemistry · 2024Article
- [Feverphobia: Frecuency and related factors associated]Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2024Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although fever is one of the main presenting symptoms of COVID-19 infection, little public attention has been given to fever as an evolved defense. Fever, the regulated increase in the body temperature, is part of the evolved systemic reaction to infection known as the acute phase response. The heat of fever augments the performance of immune cells, induces stress on pathogens and infected cells directly, and combines with other stressors to provide a nonspecific immune defense. Observational trials in humans suggest a survival benefit from fever, and randomized trials published before COVID-19 do not support fever reduction in patients with infection. Like public health measures that seem burdensome and excessive, fevers involve costly trade-offs but they can prevent infection from getting out of control. For infections with novel SARS-CoV-2, the precautionary principle applies: unless evidence suggests otherwise, we advise that fever should be allowed to run its course. Lay summary: For COVID-19, many public health organizations have advised treating fever with medicines such as acetaminophen or ibuprofen. Even though this is a common practice, lowering body temperature has not improved survival in laboratory animals or in patients with infections. Blocking fever can be harmful because fever, along with other sickness symptoms, evolved as a defense against infection. Fever works by causing more damage to pathogens and infected cells than it does to healthy cells in the body. During pandemic COVID-19, the benefits of allowing fever to occur probably outweigh its harms, for individuals and for the public at large.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.