The coronavirus could pose a severe threat to patients like President Donald Trump, data shows

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U.S. President Donald Trump exits the Oval Office as he departs on campaign travel to Minnesota from the South Lawn at the White House in Washington, September 30, 2020.

Carlos Barria | Reuters

The coronavirus works to infect all it can, world leaders included.

President Donald Trump announced early Friday that he and first lady Melania Trump tested positive for the virus. White House chief of staff Mark Meadows said the president is currently experiencing “mild symptoms.”

But the president’s health profile, at 74 years old, clinically obese and male, put him at higher risk for a potentially severe case of Covid-19.

Many people who test positive for the virus will never develop any notable symptoms or only develop a mild case of the disease, but data from the Centers for Disease Control and Prevention show that odds of becoming severely sick increase with age and the presence of underlying conditions like obesity.

A severe case of Covid-19 could require hospitalization, intensive care, or a ventilator to help the patient breathe. The disease has killed more than 207,800 people in the U.S. so far, according to data compiled by Johns Hopkins University.

“The president has multiple risk factors that all are additive, because risk is additive,” Dr. Leana Wen, former Baltimore City Health Commissioner, said in a phone interview. “If you have multiple risk factors, they all add to one another.”

While the president is currently experiencing just mild symptoms, it could take up to 12 days before more severe symptoms settle in, said Wen, an emergency physician and public health professor at George Washington University. She added that when Boris Johnson, the prime minister of the United Kingdom, was diagnosed with Covid-19 in May, he wasn’t hospitalized for nearly 10 days.

“We don’t know yet how severely he’s been infected. We know he’s positive,” Howard Markel, a physician and medical historian at the University of Michigan, said Friday. “He does have a lot of risk factors: His age, his weight and who knows about his heart, cardiovascular health.”

Dr. Syra Madad, senior director of the systemwide special pathogens program at New York City Health + Hospitals, said Covid-19 has a “very wide spectrum of illness.”

“We wish anybody that gets diagnosed with Covid-19 a good outcome, that they have a mild course,” she said. “But it’s also important to know what the realities are and to understand that if you are at higher risk that you want to make sure that you’re seeking health care services earlier.”

Here’s what we know about how the virus generally affects people with the health profile of the president:

Age

“Among adults, the risk for severe illness from COVID-19 increases with age, with older adults at highest risk,” the CDC says

Trump, 74, is the oldest first-term president in the history of the office. People between the ages of 65 and 74 have accounted for more than 21% of all Covid-19 deaths in the U.S., according to data from the CDC. People in that age group are five times more likely than those between the ages of 18 and 29 to be hospitalized, the CDC says, and 90 times more likely to die of Covid-19.

The CDC estimates that for those above the age of 70 who become infected with the virus, including those who are not diagnosed and might not develop symptoms, 5.4% will die. 

The data, however, indicates that most people of Trump’s age will recover from Covid-19, and with the availability of relatively new treatments, such as the antiviral drug remdesivir, the risk of death is lower. In the event that Trump becomes severely sick and requires oxygen, for example, doctors could use steroids like dexamethasone, which have demonstrated the ability to cut the risk of death by up to a third. 

However, underlying medical conditions can complicate the risks posed by the disease.

Underlying conditions

According to a June report from Trump’s physician, Dr. Sean Conley, the president has at least one medical condition that increases his risk profile: mild obesity.

Conley wrote that Trump was 6 feet, 3 inches tall and weighed 244 pounds at the time of the inspection earlier this year. That puts his body mass index at 30.5, meaning he is mildly obese. 

“Having obesity, defined as a body mass index (BMI) of 30 or above, increases your risk of severe illness from COVID-19,” the CDC says

Wen, the former Baltimore health commissioner, added that Trump has previously demonstrated signs of a serious heart condition. In 2018, Dr. Ronny Jackson, then the White House physician, reported that the president’s coronary calcium score had increased to 133 from 34 in 2009. A score above 100 may indicate moderate plaque deposits, which could indicate a heart disease that puts Trump further at risk.

Serious heart conditions elevate the risk associated with Covid-19, the CDC says.

Men

Of all confirmed Covid-19 deaths in the U.S., 54% have occurred in men, according to the CDC’s data. 

A study published last month in the medical journal the Annals of Internal Medicine said that the risks associated with obesity were especially pronounced in men. Researchers are still exploring why men appear to be disproportionately impacted by Covid-19.

Wen said that despite these risk factors, the chances are the president will recover, as most patients do. But the question remains, how sick will Trump become. 

“It sounds like he’s having some symptoms, but he may well have bouts that do not progress,” she said, adding that many patients’ “condition deteriorates after a week.”

“So we should not feel reassured if the president initially seems OK, because there is still a long time for us to wait to see what the trajectory of his disease is.”

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