- After testing positive for COVID-19, the president was given an experimental antibody drug along with several other treatments.
- The president’s age, weight, and gender put him at a
higher riskof severe illness from COVID-19.
- He’s taking both experimental treatments and a common steroid.
On Friday, the White House announced that President Donald Trump received an experimental antibody treatment after he tested positive for SARS-CoV-2, the virus that causes COVID-19.
The president’s age, weight, and gender put him at
He has also been taking zinc, vitamin D, the acid reflux drug famotidine (Pepcid), melatonin, and daily aspirin, reports the White House.
On Sunday, Trump’s medical team reported that after two drops in the president’s oxygen saturation level, he started taking the steroid dexamethasone.
Here’s what we currently know about the treatments that Trump is receiving for COVID-19.
The monoclonal antibody cocktail developed by Regeneron Pharmaceuticals is a combination of two antibodies that target the spike protein on SARS-CoV-2. The virus uses the spike protein to bind to and infect cells.
Scientists have previously tested this drug in golden hamsters and rhesus macaque monkeys that were intentionally infected with SARS-CoV-2. Animals given the drug had lower levels of the virus in their lower and upper airways, and fewer symptoms of the disease.
Regeneron is now testing the cocktail in nonhospitalized people who tested positive for COVID-19 and are asymptomatic or have mild or moderate symptoms.
Clinical trials of the drug are ongoing, but the company released preliminary results last week.
These data show that the drug lowered the viral load and shortened the duration of symptoms in people without detectable antibodies at the start of the study. The drug didn’t have much effect on people who already had antibodies against SARS-CoV-2.
The drug also worked better in people with a higher viral load. No information is available about Trump’s viral load before he was given this drug.
This antibody cocktail hasn’t yet been approved by the Food and Drug Administration (FDA).
Trump’s physician may have requested to prescribe the drug through the FDA’s “compassionate use” pathway for experimental treatments.
“In the case of the president, his medical staff would have carefully weighed the risks and benefits of a nonproven but early, promising treatment,” said Dr. Teresa Murray Amato, chair of emergency medicine at Long Island Jewish Forest Hills.
However, it’s difficult to know if the drug will help the president because there’s so little clinical trial data available.
Remdesivir is an antiviral drug developed by Gilead Sciences. It was previously tested as a treatment for hepatitis C and Ebola, but didn’t work well for those diseases.
A clinical trial earlier this year showed that the drug had a modest benefit for hospitalized patients with mild to moderate COVID-19.
“We have seen some positive studies using remdesivir, an antiviral medication that appears to decrease the replication of the virus, with low side effects,” said Amato.
As a result of this clinical trial, the FDA granted an emergency use authorization of the drug for patients with severe COVID-19. In August, the FDA
However, the true benefit of the drug for COVID-19 is uncertain.
While studies show that remdesivir can reduce the length of hospital stays by 4 days, it doesn’t reduce the risk of dying from the coronavirus.
Dr. Mangala Narasimhan, senior vice president of critical care services at Northwell Health, said Trump receiving remdesivir is “on target” for what doctors would do for patients admitted to the hospital for COVID-19. However, she adds that this assumes he’s like other hospitalized patients.
“It’s hard to tell how sick he is,” she said. “We’re not getting really good information.”
Dexamethasone is a common steroid that has been shown to be helpful in people with severe COVID-19. Because of the side effects, this drug isn’t recommended for people early in the course of the illness.
The National Institutes of Health’s treatment guidelines for COVID-19 recommend dexamethasone be used in patients who are on a ventilator, or who aren’t ventilated but require supplemental oxygen.
“Dexamethasone may decrease mortality of patients infected with COVID-19 who are more seriously ill,” said Amato. “It helps temper the immune response that leads to complications such as low oxygen levels (hypoxia), respiratory failure, renal failure, and other organ failures.”
However, the NIH guidelines recommend against using this drug for people who aren’t on supplemental oxygen.
Trump’s physician Dr. Sean Conley said on Sunday that the president experienced two “transient” drops in his blood oxygen saturation level — one on Friday and another on Saturday.
Trump was given supplemental oxygen on Friday for about an hour. Conley was uncertain if the president was given supplemental oxygen on Saturday.
Conley added that as a result of the drop on Saturday, the president’s medical team decided to start him on the drug.
Dexamethasone can suppress the activity of the immune system, which is why it can be helpful for people with severe COVID-19 — which can cause the immune system to overreact.
However, giving the steroid too soon may affect the immune system’s ability to fight the virus.
Dexamethasone can also cause other side effects such as nausea, vomiting, difficulty sleeping, and severe mood changes.
The NIH guidelines are supported by a clinical trial earlier this year by researchers at the University of Oxford, which showed that this drug benefited only patients sick enough to require supplemental oxygen.
“In that study, for patients who were not on [supplemental] oxygen, there was actually harm to those patients,” said Narasimhan. “So it’s a little unusual [that Trump would receive dexamethasone] if what they’re telling us about his oxygen level is true.”
“Because of the fact that they gave him dexamethasone, it feels like there’s a level of illness that we’re not getting information on,” she added.
Vitamin D and zinc are both being investigated as possible treatments for COVID-19. Both nutrients are needed for proper functioning of the immune system, but their benefit for COVID-19 is unknown.
“Some physicians in the country believe that a cocktail of zinc, vitamin D, and steroids is very beneficial in reducing the inflammatory response in COVID-19,” said Narasimhan. “But there isn’t good, hard scientific data, in terms of papers, that show that.”
In addition, a study in Spain found that COVID-19 patients with low blood levels of zinc had a greater risk of dying from the disease.
These are all observational studies, so they don’t show a cause and effect relationship between the nutrients and virus, or COVID-19 severity. However, randomized controlled trials (RCTs) of both nutrients are underway.
Famotidine, a heartburn remedy sold under the name Pepcid, has been suggested as a treatment for COVID-19. However, there’s little data to support this.
Earlier this year, a clinical trial of hospitalized patients in New York found that the drug might have some benefit for COVID-19 patients.
However, the institute that initiated that trial released a statement last week saying that the drug’s efficacy for COVID-19 is uncertain, reports Science.
The sleep aid melatonin is also in the early stages of COVID-19 clinical trials, with no results to support its use in people with COVID-19.
Other research has shown the compound to have anti-inflammatory and immune-enhancing effects in other diseases.
In animal models, it can reduce cytokines, inflammatory molecules that may contribute to the severity of COVID-19.
Trump has been taking a low daily dose of aspirin since at least 2018 to prevent cardiovascular disease, reports Vox.
Serious heart conditions