President Donald Trump pictured outside Walter Reed Medical Center in Bethesda, Maryland on October 4.
Credit: Alex Edelman/AFP via Getty Images
The range of drugs that is being taken by President Donald Trump has led to confusion in the medical community over the state of his health.
Some doctors see the prescription of the powerful steroid dexamethasone as a sign that Mr Trump is seriously unwell, while others believe that he is being over-medicated because of the number of prospective treatments that he has received while at Walter Reed hospital.
Mr Trump will be receiving dexamethasone "for the time being", according to his physicians, and has already been given the Remdesivir treatment — which has received emergency approval — plus vitamin D, an experimental antibody cocktail, and a sleeping potion.
Below is what we know about the treatments that the President is receiving, whether their use is currently widespread, and the risks that they could present.
Dexamethasone
Dexamethasone — a powerful steroid — has been used to treat Covid-19 cases since mid June after Oxford trials proved its efficacy at reducing the risk of death for more severe Covid-19 patients.
The drug can either be taken orally or as an injection, and it has since been recommended by the World Health Organisation (WHO) and the National Institutes of Health in the United States.
Dexamethasone is manufactured in the UK by firms including Martindale Pharmaceuticals and Actavis UK, as well as being produced elsewhere in countries including Turkey and the United States.
It has been on the World Health Organisation list of essential medicines since 1977 as treatment for nausea and vomiting, some allergies, and some blood tissue cancers.
For coronavirus patients on a ventilator, dexamethasone reduces the risk of dying by around one-third, while for patients who are not on ventilators it reduces the risk of death by about one-fifth.
Dexamethasone has been in use at hospitals across Europe and globally since June after the results of a successful Oxford trial.
Credit: Yves Herman/Reuters
However scientists are in agreement that there is no benefit to dexamethasone in mild patients, and the World Health Organisation cautions against using the steroids for patients who are not sufficiently sick.
The Oxford trial which took place in June found that Covid-19 mortality was somewhat higher among patients who received dexamethasone who were not being given oxygen or on a ventilator.
Use of the drug for more than two weeks can cause side effects including weight gain and mood swings.
Read more: Dexamethasone only works on serious Covid cases, says professor who led Oxford trial
Remdesivir
Remdesivir was the first treatment for Covid-19 which received a positive scientific opinion from the Medicines and Healthcare products Regulatory Agency (MHRA), based on advice from the Commission on Human medicines.
It met the criteria set out by the rapid early access to medicines scheme (EAMS), and has received "emergency use authorisation" in the United States in order to treat patients with more severe cases of the virus.
The drug has also been approved for medical use in the European Union among patients who are over the age of 12 and have pneumonia as a viral complication since July.
An ampule of remdesivir pictured at the University Hospital Eppendorf (UKE) in Hamburg, Germany.
Credit: Reuters Pool New
Data from the US National Institutes of Health found that remdesivir has been effective in reducing the average recovery time of a patient from 15 days to 11 days.
However it has not yet been approved for general use, and a report in the British Medical Journal found that it "may have little or no effect on the length of the hospital stay". Concerns have also been raised about the high price of remdesivir by scientists.
Infusion of unlicensed antibody cocktail
Taken by Mr Trump before he was transferred to the Walter Reed hospital on Friday (October 2), an antibody cocktail — produced by Regeneron — remains an experimental therapy that has not received any form of regulatory approval.
The company has said that it works best on patients who have not yet developed an immune response to Covid-19, and some believe that the synthetic antibody could turn the virus from a deadly disease into a more treatable infection.
Dr. Leonard S. Schleifer, the chief executive of Regeneron, told the New York Times that White House medical staff sought permission from the company to use the drug, which was cleared with the Food and Drug Administration.
Scientists at work with a bioreactor at a Regeneron company facility in New York state.
Credit: Regeneron
Preliminary results dating back to April showed that the Regeneron antibody cocktail showed that it does not help patients who have been admitted to hospital but are not using ventilators.
Data presented by the maker of the cocktail found that no serious safety concerns had surfaced, with the treatment shortening symptoms among those who did not have Covid-19 antibodies at the start of the trial.
Antibody cocktails are prohibitively expensive for most people, and safety concerns include ‘antibody-dependent enhancement’ — in which antibodies actually help the virus to enter human cells and reproduce — in addition to the logistical difficulties of their production.
Read more: Monoclonal antibodies could have dramatic impact on Covid fight
Vitamin D
Mr Trump has received vitamin D supplements in response to his Covid-19 infection. Arguments have been made about the vitamin and its potential impact on patients since the start of the pandemic but were initially hampered by a lack of evidence.
The National Institute of Health and Care Excellence — part of the UK’s Department for Health — ruled in June that there is no good evidence that Vitamin D protects against coronavirus, and there remains no definitive evidence of a causal link.
However some have called for a rethink after the results of the world’s first randomised control trial on vitamin D and Covid was published in late September.
The trial, which took place at the Reina Sofia University Hospital in Spain, looked at 76 patients who were suffering from Covid-19.
Of the fifty of these were given vitamin D only one became sick enough to receive intensive care, whereas half of those who were not given the vitamin ended up in intensive care.
A further study, headed by Boston University’s school of medicine, found that Covid-19 patients over the age of 40 with sufficient levels of vitamin D were more than 50 per cent less likely to die from the virus.
Sleeping potion
Mr Trump has also received a sleeping potion. There have not been any studies so far examining the link between sleeping potions and the virus.
It is likely that this has been administered to help Mr Trump sleep during his hospitalisation, rather than as a prescriptive treatment for Covid-19.
Sign up for our US election WhatsApp group for exclusive updates and behind-the-scenes access to the 2020 campaign trail.
Свежие комментарии