President Trump was flown by helicopter to Walter Reed National Military Medical Center early Friday evening “out of an abundance of caution,” the White House announced, after he was found to be infected with the Covid-19 virus. Earlier in the day, he was treated with an experimental antibody drug against the coronavirus.
“President Trump remains in good spirts, has mild symptoms, and has been working throughout the day,” the statement said. “Out of an abundance of caution, and at the recommendation of his physician and medical experts, the President will be working from the presidential offices at Walter Reed for the next few days. President Trump appreciates the outpouring of support for both he and the First Lady.”
Shortly after 6 p.m., the president walked unassisted to the Marine One helicopter on the White House lawn, for the short flight to the hospital in Bethesda, Md. He wore a mask.
In a video posted on Trump’s Twitter account soon after, Trump said: “I think I’m doing very well. But we’re going to make sure that things work out.”
It is unusual for a patient to be taken to the hospital with mild Covid-19 symptoms, doctors told STAT.
But the president is not the usual patient.
Typically, someone who has tested positive for the infection will recover at home while symptoms are mild. But if their fevers are not getting better, they’re getting dehydrated, or they become confused — especially if they are elderly — that’s a sign to seek hospital care. In the hospital, they might be put on blood thinners to combat the unusual clotting Covid-19 prompts. They could also be put on the antiviral remdesivir and, if they get sicker, the steroid dexamethasone.
The clearest trigger to seek care at a hospital is shortness of breath or other signs of low oxygen levels, such as readings from a fingertip pulse oximeter in the low 90s, experts say.
“If that is happening, if you’re getting short of breath, your oxygen levels are dropping on the pulse oximeter, it probably means that the virus is now destroying your lungs — or hurting your lungs to a degree,” said Wes Ely, a pulmonologist and critical care physician at Vanderbilt University who was speaking in general terms about Covid-19 patients. He spoke in general, before the White House announced the president would be taken to the hospital.
In a statement released Friday night, the president’s physician said Trump “is not requiring any supplemental oxygen” but had been given an initial dose of remdesivir, a Gilead Sciences drug that’s been shown to reduce the time it takes hospitalized Covid-19 patients to recover. The Food and Drug Administration granted the drug emergency authorization in May for use in patients with severe Covid-19, but in August, that authorization was broadened to include all hospitalized coronavirus patients.
Earlier Friday, Trump received an experimental Covid-19 treatment being developed by Regeneron Pharmaceuticals after testing positive for the novel coronavirus.
Data from a study of the treatment, which has not been authorized for use by the FDA, was first presented on a company conference call just three days ago. At the time, Regeneron executives said they planned to discuss what they called very promising results with regulators.
Details of Trump’s treatment were made available in a letter from Sean P. Conley, the physician to the president, which was released by the White House.
Conley wrote that, in addition to the Regeneron treatment, a cocktail of two monoclonal antibodies, Trump is also receiving zinc, vitamin D, and the ulcer drug Pepcid, all of which have been studied as possible Covid-19 treatments without definitive results, as well as melatonin, a supplement used as a sleep aid, and a daily aspirin, which is often taken by older people for cardiac reasons. The letter did not specify which treatments were being taken for Covid.
Conley also said that Trump was “fatigued, but in good spirits.”
The Regeneron treatment is a combination of two monoclonal antibodies, manufactured versions of antibodies that the immune system uses as one of its primary weapons against infection. It was created using genetically engineered mice the company developed that have immune systems much like those of humans, and which have been used to develop a number of marketed medicines for disorders like high cholesterol and debilitating skin diseases. The selected antibodies were shown in lab studies to tightly bind the protein the coronavirus uses to infect cells.
In the results released Tuesday from a 275-person study, the Regeneron treatment seemed to lead levels of the SARS-CoV-2 virus in nasal swabs taken from patients to decrease more quickly than they did in those patients who received a placebo. The patients were not hospitalized — like Trump when he received the infusion. The effect was most pronounced in patients who did not generate enough antibodies of their own. Those patients also had higher detectable levels of the virus.
Trump received the top dose of the antibody cocktail, which requires the infusion of 8 grams of monoclonal antibodies, which are given intravenously. The process generally takes about an hour.
While Regeneron said it viewed the results as potentially enough for an emergency use authorization — although the company noted that decision is made by the FDA — several other experts, including two former FDA commissioners, have said more data are needed to be certain about the treatment’s benefits and whether it would lead patients to recover more quickly or keep them out of the hospital.
Robert Califf, who was an FDA commissioner during the Obama administration, told STAT that the treatments given Trump were “not unreasonable.” He added: “But nothing he’s taken has been proven to improve outcomes, but also, none [are] likely to make things worse.”
In the Regeneron trial, serious adverse events happened in two patients who received placebo and one who received treatment, indicating that the treatment is relatively safe.
Regeneron said in a statement that the president received the treatment through a single patient investigational new drug application, a pathway open to patients “with certain established criteria and a review committee.”
“The company’s current priority is to maintain a sufficient supply of REGN-COV2 in order to conduct rigorous clinical trials that fully evaluate its safety and efficacy,” Regeneron said. “In addition to the clinical trial supply and product being manufactured under an agreement with the U.S. government, there is limited product available for compassionate use requests that have been approved under rare, exceptional circumstances on a case-by-case basis.”
Elizabeth Cooney contributed to this story.