German Doctors Warn That Those Having or Had COVID-19 Should be Careful When Using a Sauna

Medical News: For centuries, sauna bathing has been celebrated as a therapeutic practice that promotes relaxation and health benefits. Across the world, millions frequent saunas to relieve stress, enhance vascular health, and soothe aching muscles. However, a recent case report from Germany reveals that sauna use might pose serious health risks for individuals who currently have or have recently recovered from COVID-19. This Medical News report sheds light on the findings of the study conducted by researchers from Charité - Universitätsmedizin Berlin and emphasizes the need for caution.


German Doctors Warn That Those Having or Had COVID-19 Should be Careful When Using a Sauna
Image Credit: VladOrlov-Getty/Istock

The Case that Sparked Concern
The report, authored by a team from Freie Universität Berlin, Humboldt Universität zu Berlin, and the Berlin Institute of Health, detailed the tragic case of a 61-year-old woman. A regular sauna-goer, she was found unconscious by her husband after spending over 30 minutes in an 80°C sauna. Despite being healthy and active, she succumbed to a fatal subarachnoid hemorrhage, a type of brain bleed, within 38 hours of hospital admission.
 
Her medical history included complete recovery from leiomyosarcoma years earlier and no known cardiovascular issues. Notably, her COVID-19 infection had been asymptomatic and detected only through polymerase chain reaction (PCR) testing upon hospital admission. The combination of heat exposure and an active, albeit asymptomatic, COVID-19 infection appeared to have played a catastrophic role in her condition.
 
This cases study explores how the interplay between heat exposure and COVID-19 can create a deadly cascade of events, underscoring the importance of awareness and preventive measures for sauna users.
 
Heat Stroke and COVID-19: A Deadly Combination
Heat stroke, a life-threatening condition caused by excessive heat and poor thermoregulation, is well-documented as a potential risk during sauna use. It can trigger a systemic inflammatory response, disrupt the central nervous system, and lead to multi-organ failure. In this case, the patient initially displayed symptoms consistent with heat stroke, including unconsciousness, seizures, and rapid onset of disseminated intravascular coagulation (DIC), a severe blood clotting disorder.

COVID-19 further complicated the situation. The researchers noted that the virus, even in asymptomatic cases, can exacerbate inflammatory and coagulation pathways. Laboratory tests revealed significantly elevated levels of ferritin and interleukin-6 (IL-6), markers commonly associated with severe COVID-19. These factors likely contributed to the rapid progression of DIC, leading to spontaneous bleeding, including the fatal brain hemorrhage.
 
The Role of Coagulation Disorders
One of the key findings in this study was the inter play between COVID-19 and heat exposure in triggering severe coagulation disorders. The patient’s rotational thromboelastometry (ROTEM™) results revealed an almost complete lack of coagulation factors, prompting urgent treatment with prothrombin concentrate, fibrinogen, and platelet transfusions. Despite aggressive interventions, her condition deteriorated rapidly.
 
The authors emphasized that DIC, commonly associated with severe COVID-19, can present atypically when combined with external stressors such as heat. Unlike classic DIC, which often manifests with visible bleeding or bruising, this case involved delayed but catastrophic hemorrhages, including widespread petechiae and hematomas discovered during the post-mortem examination.
 
A Complex and Rapid Decline
Initial imaging studies did not show significant abnormalities, leading physicians to rule out traumatic or vascular causes. However, within hours, the patient’s pupils became unreactive, and repeat scans revealed extensive subarachnoid hemorrhage with signs of brainstem herniation. The team’s interdisciplinary consensus deemed her prognosis hopeless, and life-support measures were withdrawn in consultation with her family.
 
Autopsy findings confirmed the presence of severe brain hemorrhage and secondary hemorrhages in the pericardium and skin. The pathological report also noted signs of thermal exposure, such as skin redness and blistering, further linking her condition to prolonged heat exposure.
 
Implications for Sauna Users
This tragic case underscores the need for greater awareness among sauna users, particularly those with recent or active COVID-19 infections. The study’s findings suggest that even asymptomatic cases can amplify the risks associated with heat exposure, making it imperative to follow these safety precautions:
 
-Avoid saunas during illness or recovery: Even mild or asymptomatic COVID-19 can weaken the body’s ability to handle extreme heat.
 
-Limit sauna duration: Prolonged exposure to high temperatures significantly increases the risk of dehydration and heat stroke.
 
-Monitor for warning signs: Symptoms like dizziness, nausea, or unusual fatigue should prompt immediate exit from the sauna.
 
A Call for Further Research
The researchers highlighted the need for additional studies to better understand the interactions between heat exposure, COVID-19, and coagulation disorders. While sauna bathing has well-documented health benefits, such as improved cardiovascular function and stress reduction, its risks must not be overlooked, especially in vulnerable populations.
 
This case also raises questions about genetic predispositions to heat-induced illnesses and the role of preventive strategies, such as limiting sauna temperatures or ensuring adequate hydration, in reducing risks.
 
Conclusion
The findings presented in this study offer a sobering reminder of the hidden dangers associated with sauna use, particularly for individuals recovering from or currently infected with COVID-19. While saunas remain a cherished wellness practice, this case illustrates how a combination of external heat and viral infections can overwhelm the body’s defenses, leading to tragic outcomes.

For those who enjoy sauna bathing, it is crucial to prioritize safety by staying informed about potential risks and adhering to recommended guidelines.
 
Healthcare providers, too, must be vigilant in recognizing the signs of heat-related illnesses and their potential interactions with underlying conditions like COVID-19. Ultimately, awareness and precaution can help ensure that saunas remain a source of relaxation rather than risk.
 
The study findings were published in the peer-reviewed journal: Frontiers in Cardiovascular Medicine.
https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1476962/full
 
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