What we know about Donald Trump’s Covid-19 illness

US President Donald Trump said he was leaving the hospital Monday where he was treated for Covid-19.

Here’s what we know so far:

– When did he get infected? –

The cause of the outbreak may have been a ceremony held to announce the nomination of Amy Coney Barrett to the Supreme Court on September 26.

Trump tested positive on October 1, according to his spokeswoman Kayleigh McEnany, who has since tested positive herself.

– How did his symptoms progress? –

Trump experienced “high fever,” unusual fatigue and nasal congestion early on, according to his doctor, Sean Conley. The last time he had a high temperature was Friday.

He was hospitalized on Friday October 2, around 6:30 pm (2230 GMT).

Trump’s blood oxygen levels twice fell to worrying levels, on Friday and on Saturday respectively. At one stage it was at 93 percent saturation. 

Anything below 95 percent indicates at least “moderate” Covid-19.

The president received supplemental oxygen on Friday at the White House, and possibly also Saturday in hospital — his doctor was not clear on that point.

But he has not been on a ventilator, which happens in the most serious cases.

The president took a brief drive Sunday near the hospital to greet his supporters, attracting significant criticism for putting the Secret Service agents in the vehicle with him at risk of infection.

By Monday his vitals signs were back to normal and he was tweeting frequently — referred to as his “fifth vital sign” by observers.

– Has he suffered lung damage? –

Trump’s physician Conley was evasive when asked about the president’s lungs, saying only “there’s some expected findings but nothing of major clinical concern.”

Pressed further, he added Trump was “maxing” his lung capacity tests.

– How is he being treated? – 

First, Trump was given a high dose of an experimental antibody treatment developed by the US biotech firm Regeneron, which was administered intravenously at the White House on Friday. 

This drug is being studied in clinical trials and hasn’t yet received any form of regulatory approval, but early trial results are promising.

Trump is also on a five-day course of the antiviral remdesivir, the first medicine to receive emergency approval against Covid-19.

It’s injected intravenously once a day and works by impeding viral replication and is currently recommended for later-stage disease.

Since Saturday, Trump has also been treated using dexamethasone, a steroid intended for hospitalized patients after it was shown in a clinical trial in Britain to reduce mortality.

The drug works by dialing down an abnormal immune response that causes severe inflammation of the organs and lungs.

Conley admitted Monday the team was “in a bit of uncharted territory when it comes to a patient that received the therapies he has so early in the course.”

– Was Trump overtreated? –

Trump’s treatment course has provoked consternation among some experts. 

Jeremy Faust, an emergency doctor and public health expert at Harvard wrote a blog post Monday describing the decision to give the antibodies as “essentially an experimental Hail Mary with no track record whatsoever.”

Others suggested the president or his advisors might be pressuring the medical team to go for the “kitchen sink” approach with all three drugs at once.

“We have seen the exemplar of the VIP Syndrome whereby the patient gets irrational, lacking evidence-basis, and over-treated medical treatment,” Eric Topol, director of the Scripps Research Translational Institute told AFP.

But Gregory Poland, a professor of medicine at Mayo Clinic said that in the context of a pandemic involving a new disease, there was reasonable room for doctors to arrive at decisions based on the best current evidence.

“You’re having to do what a good physician does: there’s the science of medicine, and there’s the art of medicine,” said Poland.

– Is he out of the woods now? –

Doctors agree Trump’s improvements are positive news, but we’re only part way through a typical Covid-19 timeline.

Conley told reporters: “If we can get through to Monday with him remaining the same or improving… then we will all take that final deep sigh of relief.”

ia-ico/jm

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