How someone with Donald Trump’s medical profile might fare with COVID-19

Men who share U.S. President Donald Trump’s age and weight profile face a higher risk of developing severe disease from COVID-19, say Canadian doctors, who outlined what they’re watching for in the days to come.

Trump, who announced early Friday morning that he and his wife, Melania, tested positive for COVID-19, “remains fatigued,” his doctor said Friday afternoon. He was later taken to the Walter Reed National Military Medical Center in Bethesda, Md., where he’s expected to stay for a few days.

More commonly reported symptoms in adults include a new or worsening cough, shortness of breath or difficulty breathing, a temperature of 38 C or higher, chills, fatigue or weakness, muscle or body aches, loss of smell or taste, a headache, abdominal pain, diarrhea, vomiting and feeling very unwell, according to the federal government’s coronavirus symptoms web page.

There’s a wide spectrum of symptoms, including none at all.

Trump is 74, and older age is a strong risk factor for serious complications from COVID-19. More than 205,000 people in the U.S. who contracted the disease have died, but most people recover.

Trump and Shinzo Abe, at the time Japan’s prime minister, share a golf cart in May 2019 while playing at Mobara Country Club in Mobara, Japan. (Japan’s Cabinet Public Relations Office/Reuters)

Dr. Sumon Chakrabarti, an infectious disease specialist at Trillium Health Partners in Toronto, said being over 70 years of age is a risk factor.

“I really want to see what happens to [Trump] over the course of the next two weeks or so because he could potentially get very ill from this, and of course that’s something we don’t want,” Chakrabarti said on CBC News Network. “It’s important for him to remain in isolation and be under good observation.”

The federal government’s web page said risk increases with each decade, especially over 60 years of age.

Alberta’s government highlighted signs and symptoms to watch for in people over 65.

People living with chronic medical conditions, such as heart and kidney disease, high blood pressure, diabetes, dementia, stroke and obesity, are also at risk of more severe disease outcomes. But it doesn’t mean everyone with those attributes will have a severe consequence, doctors say.

Need for precautions applies to all

Chakrabarti said Trump’s case shows how anyone can be prone to the disease.

“That’s why it’s so important for all of us to do things that we are doing right here in Canada, things like physical distancing, the mask-wearing and washing our hands. It’s important whether you are the president of the United States or just a guy sitting on your patio at home.”

Dr. David Banach, an infectious disease physician at the University of Connecticut’s health system who is not involved in Trump’s care, said doctors will likely check the president often for difficulty breathing, coughing and other symptoms.

Dr. Matthew Oughton, an attending physician in the infectious disease division at Montreal’s Jewish General Hospital, said if someone’s symptoms develop to the point where they feel very unwell and need to seek medical care, X-rays and other tests may be done.

“Especially if the person has several risk factors, you’d want to do some investigations early on,” Oughton said. These include blood tests of certain markers of inflammation and chest X-rays if someone exhibits symptoms. Pneumonia can often appear on X-rays.

WATCH | Doctor outlines Trump’s known risk factors:

Dr. Matthew Oughton of Montreal’s Jewish General Hospital says Donald Trump’s age, weight and relative inactivity are risk factors for the novel coronavirus.  8:33

Physicians have observed that some people who test positive for COVID-19 become sicker around the 10th day of illness.

That’s what happened to British Prime Minister Boris Johnson, who was diagnosed with COVID-19 on March 26 and was admitted to hospital on April 5 with a fever and cough. He was moved to intensive care the next day and recovered after receiving oxygen.

Why excess weight poses a challenge

Dr. Sean Wharton, an internal medicine specialist and clinical researcher in obesity medicine in Toronto, said excess weight is another risk factor, particularly if carried in the middle part of the body.

“People with increased weight end up getting in the intensive care unit more often, they have more complications from COVID-19,” Wharton said. “They can have cardiac complications and lung complications at a much higher rate than those who have lower weight. That’s a major challenge.”

Trump, who is six feet three inches tall, weighed 244 pounds at his annual physical exam in June. That gives him a body-mass index of 30.5, just above 30, which is considered obese.

People who have excess weight can experience complications from COVID-19 at a higher rate than those who are a healthier weight, says Dr. Sean Wharton, an internal medicine specialist and clinical researcher in obesity medicine in Toronto. (Craig Chivers/CBC)

Abdominal fat is thought to be a significant factor because it causes inflammation that can go to the lungs and compound problems during COVID-19, he said.

Excess weight could also make it harder for the heart to pump.

Assessing an individual’s risk for medical problems depends not just on weight but also on how many diseases someone has, along with their genetic and family history, Wharton said.

Globally, for every 10 female deaths from COVID-19, there are 14 deaths in males, according to available data. Researchers are exploring potential reasons why.

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