Researchers work on treatments for outpatients, such as the president, with COVID-19 infections

As the country absorbs the news that President Donald Trump has tested positive for COVID-19, an infectious disease specialist at the Medical University of South Carolina outlined the possibilities for the 74-year-old leader.

Eric Meissner, M.D., Ph.D., said there aren’t any approved treatments yet for people with COVID-19 infection who aren’t severely ill and who are not in the hospital. Trump’s chief of staff has described the president’s symptoms as mild. “You’d be encouraged to isolate and closely monitor and treat any symptoms as they arise, as well as keep a close watch for signs that the infection could be worsening and that hospitalization may be required,” Meissner said.

The Centers for Disease Control and Prevention notes on its website that most people with COVID-19 don’t get severely sick and can recover at home. It advises them to stay there unless they need medical care. 

However, people should get immediate help if they have trouble breathing, persistent pressure in the chest, confusion, sleep trouble and bluish lips.

 

The president, with access to the best medical care available, may not get any sicker from COVID-19 than he is right now. But Meissner said Trump does have some risk factors that need to be considered – including his age. 

“I think it’s well recognized that, for a subset of people with infection, this can be a very serious illness. Any individual with COVID-19 infection who’s 74 years old, we know that that portends a higher risk for severe illness. I am certain he will be closely watched and well cared for.”

Some promising potential outpatient treatments for COVID-19 are undergoing clinical trials. That includes a national study testing a cocktail of two antibodies created by Regeneron Pharmaceuticals. MUSC is part of that trial, one of several coronavirus studies underway on its Charleston campus.

But Meissner, an assistant professor in the MUSC College of Medicine and leader of the Meissner Research Lab, said the outpatient trials have not progressed far enough to the point that there is an approved therapy for patients who are not hospitalized. “In an ideal world, we’d have some proven, efficacious outpatient therapies available to help prevent progression to severe illness. But that’s a space we’re still learning about in the context of ongoing trials.”

Inpatient treatments are showing promise as well, including convalescent plasma, antivirals and medications that can affect the immune system. “A person hospitalized for COVID-19 infection, were they to meet criteria for severe illness — for example, if they required supplemental oxygen — they would be assessed to see whether they meet eligibility for receiving the antiviral drug remdesivir. Whether they may benefit from receiving dexamethasone, an anti-inflammatory steroid that in a certain subset of people has shown potential clinical benefit, or whether they may be eligible for enrollment in a clinical trial, would also be considered,” Meissner said.

Trump’s diagnosis may shine more light on the race to get new treatments out to patients, whether they’re at home or in the hospital. Will it also raise awareness about the contagious nature of the coronavirus? Meissner isn’t sure. “Whether this impacts decision-making and beliefs in others, we’ll have to see. It certainly highlights that nobody is immune to being exposed to this infection."