TY - JOUR
T1 - Individual Factors Including Age, BMI, and Heritable Factors Underlie Temperature Variation in Sickness and in Health
T2 - An Observational, Multi-cohort Study
AU - GSTT Covid Collaborative
AU - Penfold, Rose S.
AU - Zazzara, Maria Beatrice
AU - Österdahl, Marc F.
AU - Welch, Carly
AU - Ni Lochlainn, Mary
AU - Freidin, Maxim B.
AU - Bowyer, Ruth C.E.
AU - Thompson, Ellen J.
AU - Antonelli, Michela
AU - Tan, Yu Xian Rachel
AU - Sudre, Carole H.
AU - Modat, Marc
AU - Murray, Benjamin
AU - Wolf, Jonathan
AU - Ourselin, Sebastien
AU - Veenith, Tonny
AU - Lord, Janet M.
AU - Steves, Claire J.
N1 - Publisher Copyright:
© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: [email protected].
PY - 2022/9
Y1 - 2022/9
N2 - BACKGROUND: Aging affects immunity, potentially altering fever response to infection. We assess effects of biological variables on basal temperature, and during COVID-19 infection, proposing an updated temperature threshold for older adults ≥65 years. METHODS: Participants were from 4 cohorts: 1 089 unaffected adult TwinsUK volunteers; 520 adults with emergency admission to a London hospital with RT-PCR confirmed SARS-CoV-2 infection; 757 adults with emergency admission to a Birmingham hospital with RT-PCR confirmed SARS-CoV-2 infection and 3 972 adult community-based COVID Symptom Study participants self-reporting a positive RT-PCR test. Heritability was assessed using saturated and univariate ACE models; mixed-effect and multivariable linear regression examined associations between temperature, age, sex, and body mass index (BMI); multivariable logistic regression examined associations between fever (≥37.8°C) and age; receiver operating characteristic (ROC) analysis was used to identify temperature threshold for adults ≥ 65 years. RESULTS: Among unaffected volunteers, lower BMI (p = .001), and increasing age (p < .001) was associated with lower basal temperature. Basal temperature showed a heritability of 47% (95% confidence interval 18%-57%). In COVID-19+ participants, increasing age was associated with lower temperatures in Birmingham and community-based cohorts (p < .001). For each additional year of age, participants were 1% less likely to demonstrate a fever ≥37.8°C (OR 0.99; p < .001). Combining healthy and COVID-19+ participants, a temperature of 37.4°C in adults ≥65 years had similar sensitivity and specificity to 37.8°C in adults <65 years for discriminating infection. CONCLUSIONS: Aging affects temperature in health and acute infection, with significant heritability, indicating genetic factors contribute to temperature regulation. Our observations suggest a lower threshold (37.4°C/97.3°F) for identifying fever in older adults ≥65 years.
AB - BACKGROUND: Aging affects immunity, potentially altering fever response to infection. We assess effects of biological variables on basal temperature, and during COVID-19 infection, proposing an updated temperature threshold for older adults ≥65 years. METHODS: Participants were from 4 cohorts: 1 089 unaffected adult TwinsUK volunteers; 520 adults with emergency admission to a London hospital with RT-PCR confirmed SARS-CoV-2 infection; 757 adults with emergency admission to a Birmingham hospital with RT-PCR confirmed SARS-CoV-2 infection and 3 972 adult community-based COVID Symptom Study participants self-reporting a positive RT-PCR test. Heritability was assessed using saturated and univariate ACE models; mixed-effect and multivariable linear regression examined associations between temperature, age, sex, and body mass index (BMI); multivariable logistic regression examined associations between fever (≥37.8°C) and age; receiver operating characteristic (ROC) analysis was used to identify temperature threshold for adults ≥ 65 years. RESULTS: Among unaffected volunteers, lower BMI (p = .001), and increasing age (p < .001) was associated with lower basal temperature. Basal temperature showed a heritability of 47% (95% confidence interval 18%-57%). In COVID-19+ participants, increasing age was associated with lower temperatures in Birmingham and community-based cohorts (p < .001). For each additional year of age, participants were 1% less likely to demonstrate a fever ≥37.8°C (OR 0.99; p < .001). Combining healthy and COVID-19+ participants, a temperature of 37.4°C in adults ≥65 years had similar sensitivity and specificity to 37.8°C in adults <65 years for discriminating infection. CONCLUSIONS: Aging affects temperature in health and acute infection, with significant heritability, indicating genetic factors contribute to temperature regulation. Our observations suggest a lower threshold (37.4°C/97.3°F) for identifying fever in older adults ≥65 years.
KW - COVID-19
KW - Fever
KW - Immunesenescence
KW - Infection
KW - Thermoregulation
UR - http://www.scopus.com/inward/record.url?scp=85137138652&partnerID=8YFLogxK
U2 - 10.1093/gerona/glab295
DO - 10.1093/gerona/glab295
M3 - Article
C2 - 34609487
AN - SCOPUS:85137138652
SN - 1758-535X
VL - 77
SP - 1890
EP - 1897
JO - The journals of gerontology. Series A, Biological sciences and medical sciences
JF - The journals of gerontology. Series A, Biological sciences and medical sciences
IS - 9
ER -