President Trump may be at higher risk of complications from COVID-19 given his age and weight, though doctors caution that the effects of the virus can be variable. The 74-year-old announced early Friday on Twitter that he and his wife, Melania Trump, had both tested positive for the coronavirus.
A maskless White House Chief of Staff Mark Meadows told reporters midday Friday that the president is so far experiencing mild symptoms. Less than 24 hours earlier, Trump continued with his campaign schedule, flying to New Jersey to deliver a speech at a fund-raiser at his golf club and participating in a call-in interview with Sean Hannity on Fox News from the White House.
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“The course can be highly variable,” explained Dr. David Hamer, an infectious disease specialist at Boston Medical Center. “I suspect that he’s having daily testing so he likely went from negative to positive overnight. Given his age and obesity, the next few days are going to be really key.”
Hamer said the presymptomatic phase of COVID-19 can last anywhere from two to seven days. To illustrate the insidious nature of the virus, Hamer pointed to the experience of another world leader. British Prime Minister Boris Johnson, 55, was hospitalized 10 days after testing positive back in April and spent three days in the ICU battling the disease. Johnson’s symptoms were very mild to start.
Experts have long warned the virus, which causes COVID-19, is a particular threat to those in their 70s or older, as well as those with preexisting health conditions, and people who do not exercise.
President Trump has expressed an affinity for fast food and, despite his love of golf, an aversion to exercise, telling the New York Times in 2015 that working out can be hazardous to one’s health. Even so, much of Trump’s personal health remains shrouded in mystery. In June, the White House released limited results from Trump’s annual physical, which noted he weighed 244 pounds and showed he has a Body Mass Index of 30.5, meaning he is technically obese, although at 6 foot 3 inches, just barely.
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Excess weight tends to go hand in hand with other medical conditions, like high blood pressure and diabetes, which may by themselves make it harder to fight COVID-19. In a report published in late August, researchers found that infected people with obesity were more than twice as likely to end up in the hospital and nearly 50 percent more likely to die of COVID-19. Another study, which has not yet been peer-reviewed, showed that among nearly 17,000 hospitalized COVID-19 patients in the United States, more than 77 percent had excess weight or obesity.
This answers many of your questions.
The next ten days will determine President Trump's future.
Realize the percentages on that red line are LOT higher (worse) among older men with obesity.@kutrinet pic.twitter.com/E7qCUnrQjI
— Jeremy Faust MD MS (ER physician) (@jeremyfaust) October 2, 2020
Meanwhile, Trump’s age and gender also make him susceptible to severe disease. A study published in March found that while the overall death rate for people with COVID-19 was 1.4 percent, this rose to 8.6 percent for people in their 70s. The study was based on data from China. People who test positive for COVID-19 between ages 65 and 74 are five times more likely to be hospitalized and 90 times more likely to die, compared with patients between 18 and 29, according to the CDC.
Men and women are about equally likely to be infected with the coronavirus, but researchers have observed that men often experience more debilitating and deadly symptoms. In Italy, men in nearly every age group were twice as likely as women to die of the disease. That pattern has repeated itself around the globe. A study published in July by the CDC reported that COVID-19 deaths in men outnumbered deaths in women in 41 out of 47 countries assessed. It also said that the case fatality ratio — the proportion of people with confirmed cases of COVID-19 who die of it — was more than twice as high for men as for women.
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The gender gap could be attributed to both behavioral and biological differences. Men are more likely to be smokers, which makes patients more susceptible to the worst effects of COVID-19. Trump does not smoke, nor drink alcohol. But experiments in mice also suggest that estrogen protects females from the worst effects of the coronaviruses that cause severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS). The same may apply to the coronavirus. Some scientists also suspect that male hormones called androgens, such as testosterone, may be to blame for men’s poorer outcomes.
Last November, Trump, who is the oldest president to ever hold office, underwent a two-hour unscheduled examination at Walter Reed National Military Medical Center, which the White House said was part of a routine annual physical. The results of his annual physical were not made public until more than six months later.
The summary indicated that Trump’s cholesterol had been controlled to a healthy level — at 167 total cholesterol. It was 196 last year — barely healthy — and an unhealthy 223 in 2018. Over the years, he has routinely taken a statin, a class of drugs commonly prescribed by doctors to help lower cholesterol levels in the blood. A quarter of Americans over 40 rely on the drug to avoid heart disease and stroke, according to the CDC. Still, the details of Trump’s medical history remain scant. While there is no requirement for presidents to publicly release their medical records, most do as a reassurance they are up to the rigors of the job.
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Hanna can be reached at hanna.krueger@globe.com. Follow her on twitter @hannaskrueger.
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‘The next few days are going to be really important’: Doctors weigh in on Trump’s diagnosis and risk - The Boston Globe
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