By Brianna Abbott, Sarah Krouse and Joseph Walker
President Trump, who has tested positive for Covid-19, faces
risks of a more severe bout with the virus because of his age,
gender and weight.
Most people who contract the virus experience mild symptoms and
recover. But at 74 years old, Mr. Trump is at a higher risk of
facing severe illness than younger people. The risk for a severe
case of Covid-19 increases with age, along with factors including
whether a person has other medical conditions like cancer, diabetes
or obesity, studies show.
Mr. Trump is showing mild symptoms, White House chief of staff
Mark Meadows told reporters Friday. Mr. Meadows said that the
president was in "good spirits" and "very energetic."
As a precautionary measure, the president received an eight-gram
dose of Regeneron Pharmaceuticals Inc.'s antibody cocktail, the
White House said Friday. In addition to the infusion, he has been
taking zinc, vitamin D, famotidine, melatonin and a daily aspirin,
according to the White House.
Monoclonal antibodies have shown promising early results in
treating patients earlier in the course of their disease and are
administered with a single infusion. The drugs mimic the natural
antibodies the immune system makes to fight off viruses.
The most advanced of these agents are under development by Eli
Lilly & Co. and Regeneron. Both treatments are still in
clinical trials and haven't been cleared by regulators.
Lilly said in September that 1.7% of patients receiving its
antibody drug were later hospitalized, compared with 6% of patients
who were given a placebo, in a Phase 2 study of about 450
patients.
Patients taking Regeneron's monoclonal antibody cleared more of
the virus from their systems than those taking placebos, but the
company said earlier this week that the greatest benefit was seen
in patients who hadn't yet mounted an effective immune response of
their own.
Regeneron said that Mr. Trump received the drug under a
compassionate use request, which allows unapproved medicines to be
used in patients with serious diseases who don't have other
treatment options.
A Lilly spokeswoman declined to comment.
Both Lilly and Regeneron have found that most patients with mild
to moderate disease clear the virus on their own without help from
the drugs. For the subset of patients who do develop severe
disease, antibody treatments and other drugs are thought to most
effective the earlier they are taken.
"Most patients probably don't need a neutralizing antibody,"
Lilly Chief Scientific Officer Daniel Skovronsky told The Wall
Street Journal. "They probably will get better on their own.
Unfortunately, we still can't know which patients are going to do
poorly and end up needing hospitalization."
First lady Melania Trump, who also tested positive for the
virus, said on Twitter that she had "mild symptoms but overall
feeling good."
Mr. Trump weighed 244 pounds as of his last physical, made
public in June, and stood 6 feet, 3 inches tall, which meant he
narrowly met the Centers for Disease Control and Prevention's
definition of obesity.
The obesity rate among adults in the U.S. is 42.4%, according to
the CDC. Obesity may triple the risk that a patient is hospitalized
due to Covid-19, and is linked to patients having a weaker immune
system, the agency said.
Data also suggest that men are at higher risk of dying from
Covid-19 than women, though it is unclear why. An estimated 5.4% of
people over the age of 70 who are infected die from Covid-19, the
CDC says. That compares with 0.5% for people aged 50 through 69 and
0.02% for people 20 to 49.
The president's age, gender and weight are each "a factor that
is more predictive of patients having a more difficult course,"
said David Hirschwerk, an infectious disease specialist at
Northwell Health in New York.
For those who do experience more severe disease, their symptoms
often start out mild and worsen over time, typically within a week
or so, infectious disease experts say.
"The critical week is Oct. 7 or 8 to Oct. 15," said Daniel
Griffin, chief of infectious-diseases at ProHealth Care New
York.
The president's personal circumstances correlate with better
outcomes battling the virus, Dr. Griffin says. He is white, has
access to high-quality care and received a relatively early
diagnosis.
"Being Caucasian puts him at lower risk than if he was a person
of color, " said Dr. Griffin. "And people who are diagnosed early,
followed closely and have access to the right therapeutics clearly
do better than patients without those advantages."
Most people don't end up in the hospital as a result of their
infection and recover at home, with doctors recommending rest and
fluids if patients become dehydrated. Most therapeutics or other
treatments are authorized for patients with severe disease.
Sleep is an important part of immune system health, doctors say.
Mr. Trump's infection follows weeks of campaigning. Earlier this
week he traveled to a Minnesota rally and the first presidential
debate in Ohio. He also attended a fundraiser Thursday at his golf
club in Bedminster, N.J.
Mr. Trump tweeted his test results just before 1 a.m. Eastern
Time on Friday.
Doctors monitoring Covid-19 patients recovering at home say they
should check their temperature and oxygen levels using a pulse
oximeter daily in addition to reporting any new symptoms.
A few drugs have been authorized for treatment, including the
antiviral remdesivir and convalescent plasma. The steroid
dexamethasone has also been shown in studies to help. But the drugs
are targeted for hospitalized patients, though doctors could use
them on less serious cases.
Vice President Mike Pence and Democratic presidential nominee
Joe Biden both tested negative for the virus Friday, but because it
takes two days to two weeks for the virus to incubate and become
detectable, they could still test positive within the next week or
so.
"It's hard to ignore the fact that Joe Biden was standing 20
feet away from him without a mask and in an indoor environment,"
Dr. Hirschwerk added.
--Sarah Toy contributed to this article.
Write to Brianna Abbott at brianna.abbott@wsj.com, Sarah Krouse
at sarah.krouse@wsj.com and Joseph Walker at
joseph.walker@wsj.com
(END) Dow Jones Newswires
October 02, 2020 17:37 ET (21:37 GMT)
Copyright (c) 2020 Dow Jones & Company, Inc.
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