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Risk Factors Raise Trump's Odds for Severe COVID-19

FRIDAY, Oct. 2, 2020 (HealthDay News) -- Age, weight and gender are three risk factors for severe COVID-19 illness that could complicate President Donald Trump's coronavirus infection, medical experts said Friday.

Trump announced in a 1 a.m. tweet Friday that both he and his wife, Melania Trump, had tested positive for the novel coronavirus, shortly after close advisor Hope Hicks tested positive.

Trump is 74 years old, and his height and weight -- 6 foot 3 inches, 244 pounds -- places his body mass index (BMI) around 30.5, which is considered obese.

"Age seems to be the most prominent of the risk factors. As we look at age over 60, with each 10-year interval the rate of severe illness and hospitalization increases," said Dr. David Banach, an infectious diseases expert with UConn Health in Farmington, Conn.

Weight also has been shown to play a significant role in the severity of COVID-19 illness, said Dr. Stacey Rizza, a professor of infectious diseases with the Mayo Clinic in Rochester, Minn.

"The risk factors that are consistently showing up as concerning for having a poor outcome are underlying heart or lung disease and, very strongly, obesity," Rizza said. "BMI over 30 is consistently in study after study shown to be a risk factor for having a poor outcome from COVID."

Trump also takes medicine to counter high cholesterol -- another health condition known to raise COVID-19 risks.

Not only that, but men are more likely to suffer severe COVID-19 infection than women are, experts have noted.

Banach emphasized that despite these obvious risks, "the spectrum of illness is very wide in terms of what to expect."

But because Trump falls into a high-risk group, "it will be important to monitor him for the development of symptoms and, if they occur, to assess their severity," said Dr. Amesh Adalja, a senior scholar with the Johns Hopkins Center for Health Security, in Baltimore. "People with similar risk factors are more likely to be hospitalized and have a serious course of illness, though many recover uneventfully without the need for hospitalization."

Various news outlets reported early Friday that Trump is experiencing mild symptoms of COVID-19, all citing either White House officials or people familiar with his condition.

The New York Times said Trump has had "cold-like symptoms" and seemed lethargic at a fundraiser he attended at his golf club in Bedminster, N.J., on Thursday night, after Hicks' positive test and while he was awaiting his own results.

The president came into contact with about 100 people at the New Jersey fundraising event, during which he did not wear a mask, the Times reported.

Hicks reportedly started to feel unwell on the return journey from a large campaign rally Trump held in Duluth, Minn., on Wednesday, and isolated herself on Air Force One as a precaution, Newsweek reported.

"Contact tracing would need to be performed for anyone he'd been in prolonged contact with, in order to identify these individuals and quarantine them to minimize any further spread of the infection," Banach said.

New Jersey Gov. Phil Murphy, a Democrat, is urging the people who attended the fundraiser to take "full precautions," the Times said.

Contact tracing is underway, Murphy said, and people exposed to the president should seek testing and self-quarantine.

Trump's prognosis is helped by the fact that doctors now know a lot more about COVID-19 than they did at the start of the pandemic, including what to expect and how to react to different medical situations, said Dr. David Battinelli, senior vice president and chief medical officer of Northwell Health, a New York-based health care system.

"In the past, it was a disease that we had no mental model for in terms of what's the natural history of disease," Battinelli said. "Within a few months, putting together reports from around the world, we now know the various things that could happen and the timeframe in which they could happen."

The downside is that no drugs have yet proven to be as effective in treating COVID-19 as the antivirals like Tamiflu are for seasonal influenza, Battinelli added.

"It's pretty clear that to date there is not an effective treatment, other than the best supportive care," Battinelli said. In severe cases, supportive care for COVID-19 could include IV fluids, oxygen and mechanical ventilation.

Trump's diagnosis shows that "COVID remains a major public health concern," Banach said.

"Individuals are still getting infected across the country. There are over 40,000 new cases every day. It's not a time to let our guard down," Banach said.

Rizza said that, "We know without a shadow of a doubt there are measures we can take to decrease transmission in general, which public health will continue to emphasize."

Those measures include wearing masks when near other people, sanitizing items and areas that are often touched, social distancing, and good hand hygiene.

"Those four measures we know, if everybody practiced those, would dramatically decrease the spread of the infection," Rizza said.

More information

The U.S. Centers for Disease Control and Prevention has more about COVID-19.

By Dennis Thompson
HealthDay Reporter



SOURCES: David Banach, MD, MPH, infectious diseases expert, UConn Health, Farmington, Conn.; Stacey Rizza, MD, professor, infectious diseases, Mayo Clinic, Rochester, Minn.; Amesh Adalja, MD, senior scholar, Johns Hopkins Center for Health Security, Baltimore; David Battinelli, MD, senior vice president and chief medical officer, Northwell Health; The New York Times; Newsweek

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