REGN Regeneron Pharmaceuticals Inc

By Brianna Abbott, Sarah Krouse and Joseph Walker 

President Trump, who has tested positive for Covid-19, faces risks of a more severe bout with the virus because of his age, gender and weight.

Most people who contract the virus experience mild symptoms and recover. But at 74 years old, Mr. Trump is at a higher risk of facing severe illness than younger people. The risk for a severe case of Covid-19 increases with age, along with factors including whether a person has other medical conditions like cancer, diabetes or obesity, studies show.

Mr. Trump is showing mild symptoms, White House chief of staff Mark Meadows told reporters Friday. Mr. Meadows said that the president was in "good spirits" and "very energetic."

As a precautionary measure, the president received an eight-gram dose of Regeneron Pharmaceuticals Inc.'s antibody cocktail, the White House said Friday. In addition to the infusion, he has been taking zinc, vitamin D, famotidine, melatonin and a daily aspirin, according to the White House.

Monoclonal antibodies have shown promising early results in treating patients earlier in the course of their disease and are administered with a single infusion. The drugs mimic the natural antibodies the immune system makes to fight off viruses.

The most advanced of these agents are under development by Eli Lilly & Co. and Regeneron. Both treatments are still in clinical trials and haven't been cleared by regulators.

Lilly said in September that 1.7% of patients receiving its antibody drug were later hospitalized, compared with 6% of patients who were given a placebo, in a Phase 2 study of about 450 patients.

Patients taking Regeneron's monoclonal antibody cleared more of the virus from their systems than those taking placebos, but the company said earlier this week that the greatest benefit was seen in patients who hadn't yet mounted an effective immune response of their own.

Regeneron said that Mr. Trump received the drug under a compassionate use request, which allows unapproved medicines to be used in patients with serious diseases who don't have other treatment options.

A Lilly spokeswoman declined to comment.

Both Lilly and Regeneron have found that most patients with mild to moderate disease clear the virus on their own without help from the drugs. For the subset of patients who do develop severe disease, antibody treatments and other drugs are thought to most effective the earlier they are taken.

"Most patients probably don't need a neutralizing antibody," Lilly Chief Scientific Officer Daniel Skovronsky told The Wall Street Journal. "They probably will get better on their own. Unfortunately, we still can't know which patients are going to do poorly and end up needing hospitalization."

First lady Melania Trump, who also tested positive for the virus, said on Twitter that she had "mild symptoms but overall feeling good."

Mr. Trump weighed 244 pounds as of his last physical, made public in June, and stood 6 feet, 3 inches tall, which meant he narrowly met the Centers for Disease Control and Prevention's definition of obesity.

The obesity rate among adults in the U.S. is 42.4%, according to the CDC. Obesity may triple the risk that a patient is hospitalized due to Covid-19, and is linked to patients having a weaker immune system, the agency said.

Data also suggest that men are at higher risk of dying from Covid-19 than women, though it is unclear why. An estimated 5.4% of people over the age of 70 who are infected die from Covid-19, the CDC says. That compares with 0.5% for people aged 50 through 69 and 0.02% for people 20 to 49.

The president's age, gender and weight are each "a factor that is more predictive of patients having a more difficult course," said David Hirschwerk, an infectious disease specialist at Northwell Health in New York.

For those who do experience more severe disease, their symptoms often start out mild and worsen over time, typically within a week or so, infectious disease experts say.

"The critical week is Oct. 7 or 8 to Oct. 15," said Daniel Griffin, chief of infectious-diseases at ProHealth Care New York.

The president's personal circumstances correlate with better outcomes battling the virus, Dr. Griffin says. He is white, has access to high-quality care and received a relatively early diagnosis.

"Being Caucasian puts him at lower risk than if he was a person of color, " said Dr. Griffin. "And people who are diagnosed early, followed closely and have access to the right therapeutics clearly do better than patients without those advantages."

Most people don't end up in the hospital as a result of their infection and recover at home, with doctors recommending rest and fluids if patients become dehydrated. Most therapeutics or other treatments are authorized for patients with severe disease.

Sleep is an important part of immune system health, doctors say. Mr. Trump's infection follows weeks of campaigning. Earlier this week he traveled to a Minnesota rally and the first presidential debate in Ohio. He also attended a fundraiser Thursday at his golf club in Bedminster, N.J.

Mr. Trump tweeted his test results just before 1 a.m. Eastern Time on Friday.

Doctors monitoring Covid-19 patients recovering at home say they should check their temperature and oxygen levels using a pulse oximeter daily in addition to reporting any new symptoms.

A few drugs have been authorized for treatment, including the antiviral remdesivir and convalescent plasma. The steroid dexamethasone has also been shown in studies to help. But the drugs are targeted for hospitalized patients, though doctors could use them on less serious cases.

Vice President Mike Pence and Democratic presidential nominee Joe Biden both tested negative for the virus Friday, but because it takes two days to two weeks for the virus to incubate and become detectable, they could still test positive within the next week or so.

"It's hard to ignore the fact that Joe Biden was standing 20 feet away from him without a mask and in an indoor environment," Dr. Hirschwerk added.

--Sarah Toy contributed to this article.

Write to Brianna Abbott at brianna.abbott@wsj.com, Sarah Krouse at sarah.krouse@wsj.com and Joseph Walker at joseph.walker@wsj.com

(END) Dow Jones Newswires

October 02, 2020 17:37 ET (21:37 GMT)

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