Individual Factors Including Age, BMI, and Heritable Factors Underlie Temperature Variation in Sickness and in Health: An Observational, Multi-cohort Study.
COVID-19
Fever
Immunesenescence
Infection
Thermoregulation
Journal
The journals of gerontology. Series A, Biological sciences and medical sciences
ISSN: 1758-535X
Titre abrégé: J Gerontol A Biol Sci Med Sci
Pays: United States
ID NLM: 9502837
Informations de publication
Date de publication:
01 09 2022
01 09 2022
Historique:
received:
27
07
2021
pubmed:
6
10
2021
medline:
9
9
2022
entrez:
5
10
2021
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 34609487
pii: 6381617
doi: 10.1093/gerona/glab295
pmc: PMC8513412
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1890-1897Subventions
Organisme : Medical Research Council
Pays : United Kingdom
Organisme : Clinical Research Facility
Organisme : National Institute for Health Research
Organisme : European Union
Organisme : NIHR Biomedical Research Centre
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : NIHR-funded BioResource, Alzheimer's Society
Organisme : Chronic Disease Research Foundation
Investigateurs
Rishi Iyer
(R)
Rachael Anders
(R)
Lindsay Hennah
(L)
Gitanjali Amaratunga
(G)
Abigail Hobill
(A)
Cassandra Fairhead
(C)
Amybel Taylor
(A)
Henry Maynard
(H)
Marc Osterdahl
(M)
Maria Dias
(M)
Taha Amir
(T)
Natalie Yeo
(N)
Jamie Mawhinney
(J)
Hamilton Morrin
(H)
Li Kok
(L)
Luca Scott
(L)
Aiden Haslam
(A)
Gavriella Levinson
(G)
Stephanie Mulhern
(S)
Stephanie Worrall
(S)
Thurkka Rajeswaran
(T)
Katherine Stamboullouian
(K)
Sophie McLachlan
(S)
Karla Griffith
(K)
Daniel Muller
(D)
Alice O' Doherty
(A)
Baguiasri Mandane
(B)
Irem Islek
(I)
Alexander Emery
(A)
John Millwood-Hargrave
(J)
Andra Caracostea
(A)
Laura Bremner
(L)
Arjun Desai
(A)
Aneliya Kuzeva
(A)
Carolyn Akladious
(C)
Mettha Wimalasundera
(M)
Mairead Kelly
(M)
Sally Aziz
(S)
Sinead O'Dwyer
(S)
Rupini Perinpanathan
(R)
Anna Barnard
(A)
Nicole Hrouda
(N)
Ismini Panayotidis
(I)
Nirali Desai
(N)
Hannah Gerretson
(H)
Rebecca Lau
(R)
Zaynub Ghufoor
(Z)
Hanna Nguyen
(H)
Torben Heinsohn
(T)
Jack Cullen
(J)
Eleanor Watkins
(E)
Vaishali Vyas
(V)
Daniel Curley
(D)
Niamh Cunningham
(N)
Vittoria Vergani
(V)
Kelvin Miu
(K)
Jack Stewart
(J)
Nicola Kelly
(N)
Lara Howells
(L)
Benyamin Deldar
(B)
Ross Sayers
(R)
Gracie Fisk
(G)
Sri Sivarajan
(S)
Tahmina Razzak
(T)
Helen Ye
(H)
Samiullah Dost
(S)
Nikhita Dattani
(N)
Catherine Wilcock
(C)
Gabriel Lee
(G)
Jodie Acott
(J)
Hannah Bridgwater
(H)
Antia Fernandez
(A)
Hesham Khalid
(H)
Katherine Hopkinson
(K)
Deirdre Green
(D)
Hejab Butt
(H)
Ayushi Gupta
(A)
Madeleine Garner
(M)
Hazel Sanghvi
(H)
Madeleine Daly
(M)
Emily Ross-Skinner
(E)
Shefali Patel
(S)
Danielle Lis
(D)
Informations de 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: journals.permissions@oup.com.
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