For someone with mild symptoms, it’s generally a watch-and-wait approach.
With President Trump’s revelation on Twitter that he and First Lady Melania Trump have tested positive for COVID-19, many in the public are wondering what treatment options exist for someone of President Trump’s demographic after diagnosis.
Presidential physician Dr. Sean P. Conley released a statement that said the “White House medical team and I will maintain a vigilant watch.”
Dr. John Zurlo, chief of infectious disease at Thomas Jefferson University Hospital (who is not involved in President Trump’s care), said the watch-and-wait approach is warranted for a person who is asymptomatic (not showing outward symptoms) or has minor symptoms, as there is not an approved COVID-19 treatment option in the outpatient setting. First Lady Melania Trump tweeted Friday morning that she has “mild symptoms but overall feeling good.”
For patients whose COVID-19 symptoms worsen to the severity of requiring hospitalization—particularly low oxygen levels—the FDA-approved treatment options are the antiviral medication remdesivir, which is currently administered intravenously, the steroid treatment dexamethasone, and/or convalescent plasma.
“There’s a critical time when people suddenly crash,” Dr. Zurlo said of some hospitalized COVID-19 patients. “That’s the challenge. That’s the big unknown.”
Dr. Zurlo said the medical community is working toward an active antiviral agent for COVID-19—much like Tamiflu for influenza—that would especially help those with higher risk factors for illness, such as patients who are older or who have underlying medical problems including diabetes, heart disease, and obesity. The other “Holy Grail” for COVID-19 treatment, Dr. Zurlo said, is whether monoclonal antibodies could help prevent severe infection.
According to the National Institutes of Health, monoclonal antibodies are “laboratory-made versions of proteins naturally produced by the immune system in response to invading viruses or other pathogens.” In discussing related clinical trials, the NIH states: “Monoclonal antibodies may provide short-term protection from SARS-CoV-2 and could serve as important components of the COVID-19 pandemic response until vaccines become available.”
“That’s where we’d like to be,” Dr. Zurlo said, “but we’re not there yet.”