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Sick with COVID-19? Watch for Fever Shakes, Called Rigors

Author: Stacy Kish

As news reports of the mysterious coronavirus began to emerge in January and February, it quickly became clear that this was not a normal illness. The primary symptoms associated with COVID-19 are dry cough and a high, prolonged fever, with ancillary symptoms ranging from intense fatigue to loss of the sense of smell. As each day ticks by, the self-isolating masses hunkered in front of their televisions are learning about new symptoms to watch for in their friends and loved ones.

Emily Spivak, MD, associate professor of medicine in the Division of Infectious Diseases at University of Utah Health, provides some insight on the latest information associated with the disease.

Fever Shakes

Your body mounts a fever to fight off an infection, whether it is from the new coronavirus or another virus or bacteria. In order to reset the body’s internal temperature, the body begins a series of steps. Among them, blood flows from your extremities toward your core, heart, and brain to preserve heat and increase temperature above the normal 98.6° F.

“Rigor is a sudden feeling of cold with shivering accompanied by a rise in temperature,” Spivak says. “A true rigor is unlikely to happen without a fever.”

The cooling also compels a person to seek out other sources of heat, like huddling under a blanket or putting on a sweater to get warmer. The shivering associated with rigor occurs when the muscles begin to shake to generate additional heat to warm the body faster.

Fever is helpful because it allows your body fight the infection. But Spivak notes that fever can be uncomfortable. “You can take acetaminophen (Tylenol) to bring a fever down, which would reduce rigors,” she says. “You have to try to balance treatment of fever with the fact that fever is the body’s adaptive response to try and get rid of the infection.”

Spivak is asking the community to call their health care provider or use Telehealth if you or a family member is feeling unwell, particularly for shortness of breath or a fever over 100° F, before arriving at the hospital.

Blood Oxygen Levels

A highly reported symptom of COVID-19 is shortness of breath. As the lungs become compromised by pneumonia, it is harder to draw in enough oxygen to support bodily systems. Some have touted the use of a blood oxygen monitor (also called a pulse oximeter). These small, portable devises measure oxygen saturation in blood by shining a beam of light onto the fingertip.

Clement Chow details his experience with COVID-19 in an article written for the Salt Lake Tribune. What started as a mild fever quickly escalated, leaving Chow gasping for air. His blood oxygen monitor recorded a level of 70, far below the normal 95 value. He knew he had to call for medical assistance.

While more people are purchasing these devices to determine when it might be necessary to obtain assistance from medical staff, Spivak echoes the advice of the American Lung Association and the American Thoracic Association: Healthy people should not buy a blood oxygen monitor. Rather, she encourages people to listen to their bodies.

“Our bodies will tell us when we are in trouble,” she says. “Whether or not you go to the Emergency Room depends on symptoms. If you are having a hard time breathing, call your provider to determine whether to seek care.”

According to Spivak, the only known preventative measure for COVID-19 is physical distancing, also called social distancing, and home isolation to prevent the spread of coronavirus. She also encourages people to wear a mask when in public and, of course, wash hands and high-touch surfaces frequently.

Chow is now home after a spending almost a week in the Intensive Care Unit at University Hospital. After an additional ten days of isolation from his family, he can finally hug his children again. Reflecting on his experience, he knows he is lucky. “We need to practice physical distancing to keep everyone safe, especially the health care workers,” he says.

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