5 BIGGEST Takeaways from President Trumps COVID Diagnosis – I give my medical insight from the medical update about President Trump’s COVID diagnosis and hospitalization. President Trump’s doctor, Dr. Sean Conley, gave a press conference regarding Trump’s COVID illness.

Trump’s height is 6’ 3” weight is 243. When you use the BMI calculator, that BMI comes out to 30.4, which is classified as obese. This is important because we know that obese patients have a worse prognosis with COVID. It’s also important, because its more evidence that he is making things look rosier than they really are, and when that happens, he loses credibility.

Another thing that Dr. Conley said is that day 7-10 of illness is when the inflammation phase occurs, and therefore they will monitor him closely at that time. Whether that is in the hospital or not is still TBD, it all depends on how he is doing. There are lots of COVID cases, and this is something I see in my experience as a pulmonary and critical care doctor, is that lots of times COVID starts out slow, and seemingly innocuous, and things can quickly go South. At this day 7-10 mark, if the cytokine storm is going to develop, meaning lots of inflammation in the lungs and systemic inflammation, it’s typically around this time.

5 BIGGEST Takeaways from President Trumps COVID Diagnosis

At this point, there is no doctor in the world who knows how this is going to play out. Trump can get better, he could get worse, it could happen slowly, it can happen quickly. I’ve had patients who are months out recovering from COVID. I had a patient who had symptoms with COVID, they got better, and were discharged from the hospital, they later came back to the hospital and ended up dying. There is no way of predicting this illness.

The other thing is that President Trump received this experimental therapy called REGN-COV2, which is made by a biotech company called Regeneron. It’s essentially 2 different monoclonal antibodies that are combined into a cocktail. Regeneron scientists selected two antibodies that best neutralized a version of the novel coronavirus in the lab. They then cloned these antibodies and put it into a cocktail therapy. Regeneron announced results from the first 275 non-hospitalized patients in a late-stage trial that showed that the treatment was safe and seemed to reduce viral levels and improve symptoms in patients with COVID.

The greatest improvements were seen in those who hadn’t already mounted a detectable immune response to the novel coronavirus. The patients in the trial were on average age 44 years old, and almost half the patients in the trial were obese, and about 2/3rds of them had one or more underlying risk factors for severe COVID. So there will be more data to come from this trial and from a trial involving hospitalized patients and one that is testing the antibody cocktail as prevention for people who have contact with someone in their household who has COVID.

Conley also declined to say when Trump had his last negative COVID test, which has important implications for contact tracing. Incubation time up to 14 days, average 4-7 days. But a more precise answer would come by knowing his last known negative test, and then when he tested positive. And this is absolutely something that needs to be disclosed. You have to remember that when someone contracts the virus, the virus starts to replicate, and then at some point, not right away, but at some point, that person will test positive.

Does that happen on day 1? Day 2? It’s not known exactly how many hours or days someone will test positive after they contract the virus. It’s likely a day or two, and it likely depends on different factors, so it’s variable. But this is why people who have been exposed to someone with COVID, this is why they have to be quarantined for 14 days.

So everyone who was exposed to Trump since he first contracted the virus, needs to be in quarantine. And isolation is almost the same as quarantine, except that isolation is when someone is known to have COVID. A question that often comes up is what defines exposure. And that is somewhat of a grey area. It’s loosely defined as being within 6 feet of someone with COVID who is not wearing a mask for more than 15 minutes.

Dr. Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine

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