Heat waves and health crises: The unseen threat of heat stress on multiple organ systems

Abstract

Climatological variations, triggered by global warming and rising temperatures, have become a growing concern, posing challenges to communities across the United States, Europe, and Asia. Earth heats, climate patterns shift, and the resulting climate instability triggers more persistent and powerful heatwaves, leading to significant ecological and health-related consequences. Disturbances in thermoregulation can lead to elevated core body temperature (CBT>39 °C); this typically occurs during heat stress (HS), a state wherein the body's capacity to cool itself is challenged by multiple external (environmental conditions, pathogens) or internal factors (inflammatory, metabolic, hormonal, and neurological), often precipitating systemic inflammation and multiple organ failure. HS pathological cascade involves different interconnected processes like oxidative stress, inflammation, compromised circulation, disrupted blood-brain barrier (BBB), coagulation irregularities, organ-specific responses, electrolyte imbalances, heat shock proteins (HSPs), and interactions with pre-existing conditions. To effectively address this emerging public health issue, a combined approach is needed, like incorporating pharmacological treatments such as non-steroidal anti-inflammatory drugs (NSAIDs), diuretics, muscle relaxants, vasodilators, beta-blockers, and anti-anxiety agents with essential non-pharmacological supports like public health education, cooling centres, early detection systems, and individualized plans specifically designed for high-risk groups. This review provides insight into the concept of heat-induced injury on the cellular level, the worldwide prevalence of HS, the pathogenic mechanisms behind Heat Stress-induced Multiple Organ Dysfunction (HS-MOD), and the various therapeutic strategies available.