Sauna for post-COVID-19 condition (long COVID)
Evidence review
Overview
A German retrospective case series of inpatients with post-COVID syndrome treated with a multimodal integrative program that included whole-body hyperthermia reported improved fatigue scores four weeks after discharge, with improved fatigue impact and COVID-associated symptoms; dyspnea improved only at discharge. There was no control group and other therapies were given at the same time, so the contribution of hyperthermia is unknown.
Key findings
- FACIT-Fatigue 19.1 +/- 8.4 at admission to 29.9 +/- 13.0 four weeks after discharge (p<0.001) with multimodal treatment including whole-body hyperthermia (Vagedes 2025)
- Dyspnea improved at discharge but not at 4 weeks; 63% of respondents rated hyperthermia as effective (Vagedes 2025)
Every study we reviewed
1 found benefit
Each study was checked on PubMed. The colored edge shows the direction of the result. The research library lists 5 studies on long covid, across all heat and cold therapies, including case reports and older work not graded here.
Whole-body hyperthermia as part of a multimodal treatment for patients with post-covid syndrome - a case series.
Vagedes J et al. Int J Hyperthermia. 2025. PubMed 40336247 · DOI · Free full text
- Who
- inpatients with post-COVID syndrome
- What
- whole-body hyperthermia within a multimodal integrative inpatient program
- Measured
- FACIT-Fatigue (primary), Fatigue Impact Scale, Multidimensional Dyspnea Profile, COVID-associated symptoms
- Result
- FACIT-F rose from 19.1 +/- 8.4 at admission to 29.9 +/- 13.0 four weeks after discharge (p<0.001); FIS-D and CAS improved significantly to 4 weeks; dyspnea improved only between admission and discharge; 63% of respondents identified whole-body hyperthermia as effective.
- Limitations
- retrospective; uncontrolled; multimodal treatment so hyperthermia effect not isolated; sample size not given in abstract; natural recovery possible
Protocols used in the studies
Whole-body hyperthermia was delivered to inpatients as part of a multimodal integrative program; the abstract does not give temperature, duration or number of sessions. No study has tested a sauna in long COVID.
What is still unknown
Controlled trials isolating heat from other therapies; tolerance in patients with post-exertional symptom exacerbation or orthostatic intolerance; whether outpatient sauna has any effect.
Safety
Cautions for sauna in this condition
- The abstract does not report adverse events; hyperthermia was delivered to inpatients (PMID 40336247).
- See general-safety.
For clinicians
Suggested rationale
In a retrospective case series (Vagedes 2025), fatigue scores improved after a multimodal inpatient program that included whole-body hyperthermia; there is no controlled evidence that heat therapy itself improves post-COVID symptoms.
Suggested wording only. The treating clinician decides whether it reflects their clinical judgment for this patient.
Typical ICD-10 codes: U09.9. Examples only; the clinician assigns the code.
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