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0 0.5 1 1.5 2+ Mortality 70% no CI Improvement Relative Risk Case 41% no CI Thermotherapy  Ramirez et al.  EARLY TREATMENT Is early treatment with thermotherapy beneficial for COVID-19? Retrospective study in China No significant difference in outcomes seen Ramirez et al., Medical Hypotheses, Jan 2021 Favors thermotherapy Favors control

Hydrothermotherapy in prevention and treatment of mild to moderate cases of COVID-19

Ramirez et al., Medical Hypotheses, doi:10.1016/j.mehy.2020.110363
Jan 2021  
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42nd treatment shown to reduce risk in December 2023
*, now known with p = 0.026 from 4 studies.
Lower risk for recovery.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
3,800+ studies for 60+ treatments.
Hypothesis that hydrothermotherapy (such as saunas, steam baths, or hot baths) could help prevent and treat mild to moderate COVID-19 infections. Authors note that coronaviruses are vulnerable to heat, and that fever and heat treatments may enhance the immune system's antiviral response.
Authors cite evidence of improved outcomes with hydrothermatherapy for the Spanish flu.
Authors note lower COVID-19 cases and mortality in Finland and Estonia, where sauna is part of the culture and is typically practiced at least once a week, compared with the rest of Europe.
Reviews covering thermotherapy for COVID-19 include Cohen, Kunutsor, Larenas-Linnemann, Mancilla-Galindo, Ramirez.
risk of death, 69.7% lower, RR 0.30, Finland and Estonia (sauna culture) vs. rest of Europe.
risk of case, 40.8% lower, RR 0.59, Finland and Estonia (sauna culture) vs. rest of Europe.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ramirez et al., 31 Jan 2021, China, peer-reviewed, 3 authors.
This PaperThermotherapyAll
Hydrothermotherapy in prevention and treatment of mild to moderate cases of COVID-19
Francisco E Ramirez, Albert Sanchez, Aki T Pirskanen
Medical Hypotheses, doi:10.1016/j.mehy.2020.110363
COVID-19 is a new contagious disease caused by a new coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 is a disease that has reached every continent in the world; it has overloaded the medical system worldwide and it has been declared a pandemic by the World Health Organization. Currently there is no definite treatment for COVID-19. We realize that host immunity is a critical factor in the outcome of coronavirus 2 infection. Here, however, we review the pathophysiology of the disease with a focus on searching for what we can do to combat this new disease. From this, we find that coronavirus is sensitive to heat. We have thus focused on this area of vulnerability of the virus. The emphasis of this hypothesis is on the action of body heat-internal (fever) and external (heat treatment)-in activating the immune system and its antiviral activities, and specifically related to the coronavirus. We hypothesize from this review that heat treatments has the potential to prevent COVID-19 and to decrease the severity of mild and moderate cases of Coronavirus. We propose heat treatments for this uncontrolled worldwide coronavirus pandemic while studies are being done to test the effectiveness of heat treatments in the prevention and treatment of COVID-19.
Conflict of interest statement None of the authors declare any conflict of interest. Appendix A. Supplementary data Supplementary data to this article can be found online at https://doi. org/10.1016/j.mehy.2020.110363.
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