- President Trump is being treated for the coronavirus at Walter Reed Medical Center after he announced his diagnosis on Friday.
- Trump received an IV infusion of the antiviral drug remdesivir on Friday.
- A White House official told CBS News that Trump was also given an experimental antibody cocktail Thursday night, but Trump’s medical team has suggested that he received the drug either sooner or later.
- Regardless of when, remdesivir treatment suggests Trump’s illness could be serious, doctors say.
- You can find more stories on the Business Insider homepage.
President Donald Trump is doing “very well”
“At this point, the team and I are extremely pleased with the progress the president has made,” White House doctor Sean Conley said on Saturday.
Trump received an IV infusion of the antiviral drug remdesivir on Friday. The repurposed Ebola treatment is one of two FDA-approved therapies for coronavirus patients. It is usually given to hospitalized patients who have developed a severe infection but do not need breathing apparatus or admission to the intensive care unit.
Some doctors fear that Trump’s symptoms could be more than mild.
Their suspicions are supported by the fact that before receiving remdesivir, Trump also received a dose of an experimental antibody cocktail from the biotech company Regeneron.
“The fact that he received two interventions already suggests something that is likely going on,” said Dr. Panagis Galiatsatos, pulmonologist at Johns Hopkins Bayview Medical Center, told Business Insider.
In a recent clinical study of 275 people, Regeneron’s drug was found to reduce a patient’s viral load – the amount of virus in the body. Those who received the treatment also saw that their symptoms went away faster than those who received a placebo. However, the therapy has not been approved by the FDA and has not been tested in combination with remdesivir. So doctors aren’t sure how they’re going to work together.
However, several doctors told Business Insider that giving remdesivir and the antibody cocktail early made sense as Trump is more prone to serious infections due to his age and weight.
“The idea is if you can reduce the viral load early with an antiviral agent, the progression may be stopped in some way,” said Dr. Mangala Narasimhan who oversees intensive care at Northwell Health in New York.
A confusing, contradicting timeline of Trump’s infection and treatment
On Saturday, Trump’s medical team offered a shaky schedule of when the antibody cocktail was actually administered. Dr. Ben Garibaldi told reporters the president received the cocktail 48 hours before the press conference and suggested that Trump take the drug around noon on Thursday. That was long before his diagnosis became known to the public.
But Conley then released a statement shortly after saying the president received this antibody cocktail on Friday after testing positive Thursday night. A White House official told CBS News that the drug was administered Thursday night.
Doctors and officials have also issued conflicting reports on Trump’s overall health.
Conley told reporters on Saturday that the president had no breathing difficulties and does not need oxygen. However, he declined to say whether Trump was given supplemental oxygen for his illness at any point, and the Associated Press reported that Trump actually received supplemental oxygen at the White House on Friday before going to the hospital.
The New York Times reported that the president had difficulty breathing Friday, quoting two people close to the White House. And White House Chief of Staff Mark Meadows, meanwhile, told the Associated Press that Trump had a “very worrying” period on Friday, adding that the next 48 hours would be “critical” to his treatment.
Remdesivir is usually reserved for severe cases
On average, it can take a week or more for a coronavirus patient to be hospitalized after symptoms appear. It is still unclear when Trump became infected, but the president may have shown early symptoms on Wednesday, Bloomberg News reported.
Galiatsatos said the fact that doctors administered remdesivir shortly after the antibody cocktail was a sign that Trump may have triggered a “chaotic” inflammatory response.
“If your immune system is fine, you don’t want to stop it. You don’t want to affect your remdesivir or your steroids,” Galiatsatos said. “If you felt the need to pull the trigger, my suspicion is that you are picking up some signals that he may not be doing well.”
But on Saturday, Conley stated his decision to give remdesivir as simply pursuing all options.
“I didn’t want to hold anything back,” he said. “If there was a way that this could add value to his care and speed his return, I wanted to take it.”
“Survival is only chapter one”
Trump’s doctors plan for him to take a standard five-day remdesivir course. In a memo on Friday, Conley said Trump also took zinc, vitamin D, melatonin, aspirin, and a heartburn drug. Studies have shown that vitamin D can help reduce the severity of COVID-19 infections.
“He’s doing so well, but with the known course of the disease from day 7 to day 10, we’re very concerned about the inflammatory phase,” said Conley. “Given that we offered some of these advanced therapies so early in the course, a little earlier than most of the patients we know and follow, it’s hard to tell where he is on this course. Every day, we evaluate, he does. ” must be here, what does he need and where is he going? “
He added that “all indicators are [Trump will] stay without oxygen in the future. “
For most coronavirus patients hospitalized, conditions get worse before they get better, according to Galiatsatos. Older men with pre-existing health problems tend to lose weight faster than most others, he added.
“If he follows the most common critical care phenotype, he gets sick, plateaued in a very terrible purgatory like a respirator etc for weeks before turning around,” Galiatsatos said.
Trump’s forecast is not publicly available, however. It’s also difficult for independent experts to judge due to the lack of information about when the president was diagnosed and treated, as well as conflicting reports about his need for supplemental oxygen. When doctors announce they have administered a steroid, Galiatsatos said, it is a sign that Trump’s condition has likely worsened.
Regardless of what happens in the future, patients who are hospitalized with the coronavirus tend to face a long recovery.
“Survival is only chapter one,” said Galiatsatos. “What doesn’t kill you about COVID-19 doesn’t make you stronger. It makes you weaker. So he has to realize that if he survives the worst, he has a long way to go.”
Andrew Dunn contributed to the coverage.