BMH Med. J. 2021; 8(3): 110.   Special Article

Profuse Continuous Sweating: An Early Sign of Cytokine Storm in COVID 19

Raveendran AV

Specialist in internal medicine Badr Al Samaa, Barka, Sultanate of Oman

Address for Correspondence:  Dr. Raveendran AV, Specialist in Internal Medicine, Badr Al Samaa, Barka, Sultanate of Oman. E mail: raveendranav@yahoo.co.in

Excessive sweating is usually seen along with fever due to any etiology. Fever associated with rigor and chills seen in conditions like malaria, urinary tract infections and cholangitis. Excessive sweating is also a feature of various metabolic and endocrine disorders like hyperthyroidism, hypoglycemia and pheochromocytoma. Cardiac and cerebro vascular insult can present with excessive sweating.

Patients with COVID-19 develop cytokine storm in the second half of illness, which contribute to increased morbidity and mortality. Early identification and appropriate treatment is lifesaving during this pandemic. Cytokine storm is an acute hyper-inflammatory response seen in these patients leading to dysfunction of various organ systems resulting in critical illness [1]. 

In patients with COVID-19, sweating along with fever is a common symptom. But profuse continuous sweating even when afebrile is seen in some patients admitted with COVID-19. All those with profuse continuous sweating with normal body temperature developed severe cytokine storm subsequently. In our limited experience, we noticed that profuse continuous sweating even when body temperature is normal in patients with COVID-19 is an early sign of impending cytokine storm.

So unexplained new onset sweating in people with COVID-19 infection should be taken as an early sign of excessive immune/ inflammatory response and plan aggressive treatment and monitoring to reduce future complications.

Reference

1. Fajgenbaum DC, June CH. Cytokine storm. N Engl J Med 2020;383:2255-2273.