COVID-19 presents with a wide array of symptoms. While many focus on cough and fatigue, excessive sweating, including night sweats, is a reported symptom. This experience, though uncomfortable, often represents a normal physiological response as the body works to combat the infection.
Fever and the Body’s Cooling Response
One reason for sweating during COVID-19 is the body’s natural response to fever. When fighting an infection, the hypothalamus, which controls temperature, raises the body’s core temperature. This elevated temperature helps activate immune cells to destroy infectious agents. As the immune system gains control and fever subsides, the hypothalamus resets its temperature. To cool the body, sweat glands become active, releasing sweat that evaporates from the skin, dissipating heat, which can lead to significant sweating, particularly as the fever breaks or fluctuates, often resulting in night sweats.
Immune System and Inflammatory Pathways
Beyond fever, the immune system’s response to SARS-CoV-2 can also influence sweating. When the body encounters a viral threat, it releases inflammatory chemicals called cytokines. These cytokines are crucial for immune cell communication and directing inflammatory responses. In some severe COVID-19 cases, this inflammatory response can become dysregulated, leading to an excessive release of pro-inflammatory cytokines, often called a “cytokine storm.” High levels of these mediators can impact the brain’s thermoregulatory center, causing increased sweating, even without a high fever, and profuse sweating without fever has been observed as an early sign of an impending cytokine storm in some COVID-19 patients.
Autonomic Nervous System Dysregulation
Another factor contributing to sweating in COVID-19 is its impact on the autonomic nervous system (ANS). The ANS regulates involuntary bodily functions, including temperature control and sweating. The SARS-CoV-2 virus can disrupt the ANS, leading to dysregulation. This can manifest as excessive or unusual sweating patterns, sometimes persisting after the acute infection. Conditions like orthostatic intolerance, which can include sweating, have been linked to Long COVID, and theories suggest the virus might directly affect the nervous system or trigger an immune response that impacts ANS function.
When to Consult a Doctor
While sweating is often a normal part of illness, certain signs warrant medical attention. Consult a healthcare professional if sweating is accompanied by a persistently high fever, difficulty breathing, or chest pain. Other concerning symptoms include new confusion, inability to wake or stay awake, or a pale, gray, or blue discoloration of the skin, lips, or nail beds. Medical advice is also important if sweating is severe, disrupts sleep significantly, or is coupled with unexplained weight loss or severe weakness. These symptoms could indicate a more severe infection or potential complications, such as pneumonia or dehydration. Prompt medical evaluation can help ensure appropriate management and rule out serious underlying issues.
Strategies for Managing Sweating
Managing excessive sweating during illness can improve comfort. Staying well-hydrated is important, as sweating can lead to fluid loss; drinking plenty of water or electrolyte-rich fluids helps regulate body temperature and replace lost fluids. Wearing lightweight, breathable clothing like cotton can help sweat evaporate more easily, keeping the body cooler. Keeping the environment cool and well-ventilated, using fans, or taking cool showers can also provide relief. Using absorbent materials on bedding can help manage night sweats. Maintaining good personal hygiene, including regular washing, helps keep the skin clean and dry.