Donald Trump’s age and weight may cause Covid complications, doctors say

Doctors have warned that the US president, Donald Trump, has numerous factors placing him at risk of complications from Covid-19, including his age and being overweight.

The 74-year-old on Friday announced on Twitter that he and his wife, Melania Trump, had both tested positive for the virus. A study published in March in medical journal, The Lancet, found that while the overall death rate for people with Covid-19 was 1.4%, this rose to 8.6% for people in their 70s. The study was based on data from China.

Dr Barry Dixon, an intensive care physician at St Vincent’s hospital in Melbourne, said Trump’s risk would increase if he developed pneumonia, which is associated with a high Covid-19 mortality rate, especially in patients over 65 and those who have cardiovascular disease or conditions affecting blood vessels of the brain.

“He’s at a much higher risk of dying if he does develop that bad pneumonia,” Dixon said. “There are other risk factors and co-morbidities such as whether you are a heavy smoker, have diabetes, or have heart disease. The key risk factors for Trump that we know about are his age and the fact he’s overweight, and they’d be high-risk factors.”

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Dixon said mild symptoms at onset were not an indicator that someone would avoid more severe disease. He said it was around the one-week mark where people either seemed to improve or decline rapidly.

“We tend to see people with very mild symptoms for the first week, that is typical, and in the second week typically people either develop pneumonia or not,” he said.

“If you see someone who just got it, they’ve just tested positive, typically they look well. But we would tell those patients to isolate at home and to come to hospital if they feel short of breath. Because in that second week of the virus, people can go from looking very good to pretty rotten even over just 24 to 48 hours.

“It’s a quick deterioration, and that’s what we saw with [British prime minister] Boris Johnson.”

Infectious diseases physician Prof Peter Collignon said he would have concerns for “anyone with Covid” given there was mortality associated with the virus.

“My advice would be first of all, check his underlying conditions such as heart and lung conditions, and from there you’d make an assessment of whether he stays home or goes to hospital,” he said.

“If he’s well enough to walk and breathe OK, then he’d be fine to go home for a while. But a proportion will deteriorate between five to seven days later, so you’d need to monitor how he is breathing and how he looks.”

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Prof Christine Jenkins, head of the respiratory group at The George Institute for Global Health, said while “Trump’s ideas about prophylactic hydroxychloroquine treatment and disinfectants were fake news”, he would likely benefit from the many evidence-based scientific advances made.

It was difficult to say what his chances of being admitted to intensive care or dying from the virus were, she said, because these statistics were changing frequently as treatment improved.

“Early on we thought if you had Covid, were admitted to intensive care and over 70, you had only a 40-to-50% chance of survival,” Jenkins said. “Today, those figures are not that bad, and we have had study results come out with promising findings about treatments for people who do become severely unwell, such as the drug dexamethasone.”

She added that ventilators were not being used as readily, as evidence was showing they could do more harm than good when used too soon.

“Trump is now the beneficiary of very powerful learnings from evidence-based science,” she said.

Jenkins said it was also difficult to assess Trump’s risk without having access to his medical records. But based on age alone he should be concerned, she said.

“When you look at Mr Trump, he looks overweight to me, and he’s 74,” she said.

“I don’t know if he has hypertension or a history of glucose intolerance, but he is the sort of person I believe who would not want anyone to know about those vulnerabilities and may not be forthcoming if he had them.”

Prof Collignon agreed that even for those that developed pneumonia and blood clots in their lungs, and who were admitted to intensive care, there was a slightly higher survival rate now compared with early in the pandemic due to lessons learned.

“People are being better treated with supportive care now as we learn a bit more about the virus,” he said.