Whole-body hyperthermia as part of a multimodal treatment for patients with post-covid syndrome – a case series, 2025, Vagedes et al

Whole-body hyperthermia as part of a multimodal treatment for patients with post-covid syndrome – a case series

Jan Vagedes, Thomas Breitkreuz, Victoria Heinrich, Mohsen Sobh, Mohammad Oli Al Islam, Katrin Vagedes, Jan Mergelsberg

Background
Post-Covid syndrome (PCS) has been an ongoing challenge since the COVID-19 pandemic. Relatively little is known about the effect of whole-body hyperthermia (WBH) in the treatment of PCS.

Methods
We retrospectively analyzed the data of patients with PCS who were treated as inpatients with a multimodal integrative therapy approach including WBH. The primary outcome comprised changes in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) between T0 (at hospital admission) and T2 (four weeks after discharge), secondary outcomes were changes in Fatigue Impact Scale (FIS-D), Multidimensional Dyspnea Profile (MDP) and Covid-Associated Symptoms (CAS) between T0–T1 (at discharge) and T0–T2.

Results
FACIT-F yielded a significant increase (p < 0.001) between T0 (19.1 ± 8.4) and T2 (29.9 ± 13.0) (primary outcome), indicating an improved health status. While FIS-D and CAS scores improved significantly between T0 and T2, dyspnea parameters improved only between T0 and T1. 63% of respondents identified WBH as an effective treatment.

Conclusions
Study results provide preliminary evidence for potentially positive effects of WBH in the setting of this study, in which it is embedded in a multimodal therapy approach. The results should be substantiated by future RCTs to identify specific effects of individual therapy components.

Link | PDF (International Journal of Hyperthermia) [Open Access]

 

https://www.facit.org/measures/facit-f

While I am glad people are taking a look at thermal aspects of illness management, I would like to see empirical measures for outcomes which do not rely on self reporting because subjectivity is so subject to bias and there is no blinding thermal treatments.

There are a few things to consider in relation to thermal impacts on illness.

My own (subjective) experience of ME/CFIDS with ACAI (atypical chronic active infection) causing recurring infections is that some viruses appear to recur in relation to body temperature. The concept of "catching" a chill may be related and a widespread occurrence of this phenomenon which everyone takes for granted without considering what it really means, due to a medical dogma that viruses do not persist, when we know many do.

Thermal treatment may inhibit pathogen replication and favour immune cell activity in the same way running a temperature is thought to do.

In addition, thermal treatments cause changes to blood flow due to thermoregulation responses of the patient causing vasodilation which can improve blood flow to all parts of the body and reduce blood pressure. Vasodilation may directly interact with the pathogenicity of covid due to the affinity of virus spikes for ACE2 receptors which normally help to downregulate blood pressure by causing vasodilation.

I think we could all benefit from understanding these things better in various contexts, so I am glad to see people making a start on understanding the impacts of heat therapy.

 

I became extremely heat sensitive after I got ME/CFS, so this would be like torture for me. Isn’t temperature sensitivity an optional part of the CCC?

But I also know people that do a lot better during the summer. So this might be tolerable for a certain subset?