What COVID-19 treatments could President Trump get?


  • World
  • Saturday, 03 Oct 2020

FILE PHOTO: U.S. President Donald Trump and first lady Melania Trump board Air Force One as they depart Washington on campaign travel to participate in the first presidential debate with Democratic presidential nominee Joe Biden in Cleveland, Ohio at Joint Base Andrews, Maryland, U.S., September 29, 2020. Picture taken September 29, 2020. REUTERS/Carlos Barria

(Reuters) - U.S. President Donald Trump on Friday said he and his wife Melania had tested positive for COVID-19 and were going into quarantine.

Trump, 74, is experiencing mild symptoms, the White House said. The most common symptoms of the disease are cough, fever and sore throat. Trump's gender, age and weight make him more vulnerable to developing severe COVID-19, and give him a notional risk of around 4% of dying from it, health experts said.

WHAT ARE THE TREATMENTS FOR 'MILD' COVID-19?"There are no treatments to date that have been really established to be effective in this phase of illness. At this point, it is really symptomatic and supportive care," Dr. Jonathan Grein, director of hospital epidemiology at Cedars-Sinai Medical Center in Los Angeles, who is not involved in treating Trump, said in a telephone interview.

Grein said the president is likely being closely monitored, and would be given extra oxygen or fluids if needed. Supportive care would depend on symptoms: things like cough syrup or fever-reducing drugs.

HOW ABOUT EXPERIMENTAL TREATMENTS?

One of the most anticipated classes of experimental COVID-19 drugs is monoclonal antibodies: manufactured copies of human antibodies to the virus that are being studied for use in patients with early illness. They could be given to the president in the context of a clinical trial or a compassionate-use program.

The technique is already in wide use for treating a range of illnesses. Data so far is limited for COVID-19 antibodies, but U.S. infectious disease chief Dr. Anthony Fauci is among those saying it has promise.

Regeneron Pharmaceuticals Inc, one of the leaders in this area, has reported improved symptoms in non-hospitalized COVID-19 patients, with no serious side effects. Eli Lilly & Co has also announced early data from a trial of its coronavirus antibody, and said it is seeking an emergency use authorization from the Food and Drug Administration (FDA). Neither company responded to a request for comment.

"Obviously, the president is a very unique case. ... I am sure his clinical team is looking at everything," Dr. Grein said.

HOW ABOUT HYDROXYCHLOROQUINE?

Trump early in the pandemic backed the idea of using anti-malaria drug hydroxychloroquine to treat COVID-19. In May, the president said he was taking the drug to prevent an infection. The FDA initially allowed use on an emergency basis but in June withdrew that authorization after determining that hydroxychloroquine was not effective.

WHAT HAPPENS IF TRUMP'S CONDITION WORSENS?

If the president's condition deteriorates - for instance, he developed breathing problems - he would be hospitalized. "It is not uncommon for patients to have symptoms for several weeks. Some can get worse well into the second week of illness," Dr. Grein said.

For patients hospitalized with COVID-19, the FDA has given emergency-use authorization for two treatments: Remdesivir, an intravenous antiviral drug sold by Gilead Sciences Inc, which has been shown to shorten hospital stays, and convalescent plasma, which is derived from the blood of people who have survived the disease and carries antibodies that can help a patient fight COVID-19.

Hospitals also commonly use the generic steroid dexamethasone, which was shown in studies to improve survival for patients hospitalized with critical COVID-19 who need extra oxygen. But the steroid should not used in people with mild illness since it can limit the body's own ability to combat the virus, according to guidelines from the Infectious Disease Society of America.

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