Is Coronavirus disease 2019 (COVID-19) contagious in the absence of fever (pyrexia)?

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Last updated: May 18, 2025View editorial policy

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From the Guidelines

Yes, COVID-19 can be contagious even when a patient does not have a fever. Infected individuals can spread the virus before developing symptoms (pre-symptomatic transmission), while experiencing mild symptoms without fever, or without ever developing symptoms at all (asymptomatic transmission) [ 1 ]. Temperature screening alone is not sufficient to identify all infectious cases. The SARS-CoV-2 virus primarily spreads through respiratory droplets and aerosols when an infected person breathes, talks, coughs, or sneezes, regardless of whether they have a fever.

Key Points to Consider

  • The onset of symptoms occurs around 3–5 days from initial infection, with fever being one of the most frequently experienced symptoms [ 1 ].
  • Pre-symptomatic transmission has been suggested as one of the features that promote the widespread transmission of the virus [ 1 ].
  • The virus's ability to spread without obvious symptoms like fever is one reason COVID-19 has been challenging to control and why testing, even of people without symptoms, has been an important strategy in many settings.

Prevention Measures

  • Public health measures like wearing masks, maintaining physical distance, ensuring good ventilation, and practicing hand hygiene remain important for preventing transmission.
  • These measures are crucial in reducing the spread of the virus, especially in settings where people may be infected but not showing symptoms like fever.

From the Research

COVID-19 Contagiousness

  • The provided studies do not directly address the question of whether COVID-19 is contagious when the patient does not have a fever 2, 3, 4, 5, 6.
  • These studies focus on the treatment and management of COVID-19, including the use of remdesivir and dexamethasone, and their effects on patient outcomes such as mortality, hospitalization duration, and viral clearance.
  • None of the studies provide information on the contagiousness of COVID-19 in patients without a fever, making it difficult to draw conclusions on this topic.

Related Findings

  • The studies do suggest that COVID-19 can be contagious, as they discuss the transmission of the disease and the importance of treatment and management to prevent further spread 2, 3, 4, 5, 6.
  • However, the specific question of contagiousness in patients without a fever is not addressed, and therefore, no conclusions can be drawn from the available evidence.

Limitations

  • The provided studies have limitations, including their focus on specific treatments and patient populations, which may not be representative of all COVID-19 cases 2, 3, 4, 5, 6.
  • Additionally, the studies may not have considered the role of fever in contagiousness, which could be an important factor in understanding the transmission of COVID-19.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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