Could a fever help the sickest COVID-19 patients?

The thought of developing a fever — one of the most common symptoms of COVID-19 — is terrifying for many of us these days. For Dr. David Willms, fevers could be a way to save more lives.

Dr. Willms, director of critical care for Sharp Memorial Hospital, is serving as principal investigator for a new clinical trial exploring whether a fever could help someone recover from severe COVID-19. It’s a potential treatment that hasn’t been studied anywhere else in the world.

“We’ve long known there are some benefits to fever, which is the body’s natural response to an infectious disease,” says Dr. Willms. “In addition to slowing down a disease’s ability to replicate, our immune system just seems to work better when we have a fever. Like other respiratory illnesses, COVID may be particularly sensitive to fever. We’re curious to see whether it can help the sickest patients recover faster.”

Although fever is one of the earliest signs of COVID-19, fevers are typically gone by the time someone becomes critically ill with the disease. So, doctors at Sharp Memorial will need to induce a fever in patients who are selected for the clinical trial. To do so, they will insert a special instrument into a patient’s esophagus that increases body temperature from the inside.

The device has long been used to help regulate patient temperatures in critical care units, operating rooms and emergency rooms. Placed within the esophagus, the device is located close to the body’s core, where blood flow from the heart and in the great vessels can quickly reach the rest of the body.

Outside of the body, the device is connected to an external heat exchange unit that warms or cools water. The water travels in a tube to and from the esophagus via a closed-loop system, allowing for a highly controlled transfer of heat. Ultimately, only a fever of a few degrees may help doctors see if there is a difference in recovery times.

The initial clinical trial will include 20 patients — 10 of whom receive the induced fever and 10 in a control group. If results suggest the treatment may be effective, a larger trial involving other hospitals will begin.

“It’s critical to do valid scientific studies, especially during a pandemic,” Dr. Willms says. “The sooner we engage in effective and scientifically valid research, the more we will know and the more lives we will save.”

It’s not surprising that Dr. Willms is leading this clinical trial. Science has always guided his 32 years of caring for some of the sickest patients in San Diego. Dr. Willms has seen firsthand how evidence-based medicine can make a profound impact on whether someone lives or dies. And since March, he has spent nearly every day in the ICU caring for patients severely ill with COVID-19.

“This is not a typical respiratory illness,” says Dr. Willms. “Many more patients are developing severe disease, and they are sicker for much longer. This virus appears to attack blood vessels, leading to organ failure, clotting and inflammation — effects we’ve not seen before.”

Over the last several months, he’s closely followed new medical studies that have revealed the benefits of certain medications. Several of those treatments are now options for patients at Sharp Memorial with severe COVID-19.

His plea to the public: Please pay attention to science and scientists.

“There’s a lot of incorrect information out there,” Dr. Willms says. “Ask questions about where the information is coming from and whether that source is credible. We should approach COVID-19 the same way we’ve approached cancer treatments, which have improved so much in the past few decades through valid studies, evidence and verified data.”