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President Donald Trump and first lady Melania Trump have tested positive for COVID-19 and “will begin our quarantine and recovery process immediately.”

USA TODAY

Just how serious can COVID-19 be for someone of President Trump’s age and condition?

Everyone reacts differently to the coronavirus that causes COVID-19, from no symptoms at all to life-threatening illness.

“What we’ve learned for sure is that the spectrum of illness from COVID-19 is tremendous,” said Dr. David Banach, an infectious diseases physician at UConn Health and hospital epidemiologist at the UConn John Dempsey Hospital.

President Trump has several risk factors that put him on the more worrisome end of the spectrum, but others that counterbalance the risk.

His age, weight and gender all add to his vulnerability.

Trump turned 74 in June, putting him at five-times higher risk of hospitalization and 90-times higher risk of death than someone in their 20s, according to data from the U.S. Centers for Disease Control and Prevention. Just a year older, and he’d be at eight-times higher risk of hospitalization and 220-times higher risk of death.

The President’s weight-to-height ratio bumps him just over the boundaries of what’s considered obese, putting him at three-times higher risk of a serious infection compared to someone at a healthier weight, according to the CDC.

Being male also puts Trump at higher risk. Just over 54% of Americans who have died of COVID-19 have been male, while 46% have been female; in Trump’s age group, 61% of the deaths have been among men.

The First Lady, who also tested positive for COVID-19, has none of these added risks, and so is likely to have a mild case of the disease.

President Donald Trump and first lady Melania Trump have tested positive for COVID-19 and “will begin our quarantine and recovery process immediately.” (Photo: Getty)

The President also has a number of strengths to counteract his risks.

First, he’s healthy and very active.

He keeps a busy schedule for someone of his age, and his health does not appear to interfere with the activities of his daily life. Risk of serious COVID-19 illness is known to increase as medical conditions mount, with the highest risk among those who have three or more comorbidities, such as asthma, obesity, diabetes, chronic kidney disease, severe obesity, coronary artery disease, history of stroke, and a lung condition called chronic obstructive pulmonary disease or COPD.

Trump also has access to the best possible medical care, potentially including some therapies that could reduce his risk of having a bad case of COVID-19.

Although no therapies have yet been approved, there are several under development that can be given after exposure to the virus and are likely to be safe and limit symptoms. It’s not clear whether Trump has received or will receive any of these.

Monoclonal antibodies, for instance, are proteins that help the immune system fight off a specific invader, and can be used to prevent, protect or treat many diseases. Several companies have been developing monoclonal antibodies against COVID-19, and although none has yet been approved for sale, there are clinical trials in which Trump could potentially participate.

Dave O’Connor, a pathologist at the University of Wisconsin, said if he were the President and had ready access to cutting edge therapies, he’d either be signing up for a monoclonal antibody clinical trial or be asking for an injection of Remdesivir, an anti-viral authorized for use in hospitalized COVID-19 patients.

If such preventive therapies are offered to the President, O’Connor said he’d hope they’d also soon be available to the general public. 

“What does the best care look like?” he asked, and “how closely is the care available to everyone else approximating that?” 

But Dr. Mark Rupp, chief of the division of infectious diseases at Nebraska Medical Center in Omaha, said if Trump were his patient, he would simply watch over him carefully for the next week.

“The most important thing is clearly having careful observation and really good supportive care,” Rupp said. “Until we have further data, I would be reluctant to embark on any therapy.”

Rupp said with most people, the first week after symptoms appear is key. During that time, patients either turn the corner and begin to improve, or they deteriorate and potentially need medical care.

“I think we’ve got a critical period of about a week to watch closely and try to make sure the president turns the corner in the right direction,” he said.

Contact Karen Weintraub at [email protected] and Elizabeth Weise at [email protected]

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

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