By Brianna Abbott, Sarah Krouse, Joseph Walker and Sarah Toy
President Trump, who has tested positive for Covid-19, took an
experimental Covid-19 drug that has shown promise reducing virus
levels in early-stage patients but hasn't finished being tested or
been cleared for use by regulators.
As a precautionary measure, the president received an eight-gram
dose of Regeneron Pharmaceuticals Inc.'s antibody drug cocktail,
the White House said Friday.
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.
The company describes its drug as providing a substitute immune
response for patients who haven't mounted their own yet and who
have high virus levels in lab tests.
"Older people are among those who have trouble mounting an
immune response, which would mean that they have less ability to
fight the virus," said George D. Yancopoulos, Regeneron president
and chief scientific officer. These patients "should benefit the
most from getting an immune response from the outside," he
said.
White House officials said Mr. Trump, who is 74 years old, was
experiencing mild symptoms after his diagnosis. The infusion of the
Regeneron drug was among a number of precautions being taken with
the president, including his transport to Walter Reed National
Military Medical Center where he will work from the presidential
offices there the next few days.
Most people who contract the virus experience mild symptoms and
recover. Yet 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 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 age 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.
Yet 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.
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. Yet the drugs
are targeted for hospitalized patients, though doctors could use
them on less serious cases.
Monoclonal antibodies have shown promising preliminary 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 the U.S. Food and Drug
Administration.
Patients taking Regeneron's monoclonal antibody cleared more of
the virus from their systems than those taking placebos in an
early-stage trial, 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.
"The more recent the infection, the more likely it is that you
haven't mounted an immune response, which would put you in the
ideal category of potentially being helped" by Regeneron's drug,
the company's Dr. Yancopoulos said.
Aside from getting the antibody drug, Mr. Trump has been taking
zinc, vitamin D, famotidine, melatonin and a daily aspirin,
according to the White House.
Doctors may give the vitamins and minerals to Covid-19 patients
because they are relatively safe and might give the immune system a
boost, but there is no definitive evidence that they actually
provide benefit to prevent or treat Covid-19, doctors said.
"A lot of this is theoretical," said Paul Marik, chief of the
division of pulmonary and critical-care medicine at Eastern
Virginia Medical School, who said he gives to his patients a
regimen similar to what Mr. Trump has been taking. "We don't have
definitive data that it works, but it makes good sense and it's
safe."
A paper published last month in the journal PLOS ONE found a
higher rate of coronavirus cases in people who were deficient in
vitamin D than in people who had normal levels of vitamin D, though
scientists say more research is needed.
Aspirin could help reduce the risk of clotting, which Covid-19
patients are more prone to, doctors said.
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."
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.
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.
Write to Brianna Abbott at brianna.abbott@wsj.com, Sarah Krouse
at sarah.krouse@wsj.com, Joseph Walker at joseph.walker@wsj.com and
Sarah Toy at sarah.toy@wsj.com
(END) Dow Jones Newswires
October 02, 2020 20:23 ET (00:23 GMT)
Copyright (c) 2020 Dow Jones & Company, Inc.
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