Home >Science >Health >If I catch covid-19, can I get the medications Donald Trump received?
 Washington:President Donald Trump arrives to speak from the Blue Room Balcony of the White House to a crowd of supporters, Saturday, Oct. 10, 2020, in Washington.  AP/PTI Photo(AP11-10-2020_000006A) (AP)
Washington:President Donald Trump arrives to speak from the Blue Room Balcony of the White House to a crowd of supporters, Saturday, Oct. 10, 2020, in Washington. AP/PTI Photo(AP11-10-2020_000006A) (AP)
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If I catch covid-19, can I get the medications Donald Trump received?

Here’s what we know about treatments Trump received—and how a person on some of those medicines might be faring at this point in their care

Here’s what we know about treatments Trump received—and how a person on some of those medicines might be faring at this point in their care

It has been more than a week since President Trump was diagnosed with Covid-19, the illness caused by the novel coronavirus, and his physician said Thursday that he has completed his course of therapy. Here are some answers to questions about the treatments the president received.

Which medications did the president receive?

The president got a monoclonal antibody treatment made by Regeneron Pharmaceuticals Inc., the antiviral remdesivir, made by Gilead Sciences Inc., and the steroid dexamethasone. “He’s getting the state of the art, the trio of best drugs," said Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco.

If I get Covid-19, will I be prescribed those medications?

Dexamethasone and remdesivir are now routinely used in treating hospitalized Covid-19 patients. The monoclonal antibody drug made by Regeneron is in clinical trials and hasn’t been approved by regulators for emergency use.

The president got a dose of Regeneron’s drug, called REGN-COV2, because of a program that allows patients to take experimental drugs outside of clinical trials. It is in limited supply, and it is unlikely most people would be able to get the drug any time soon. The company said in a recent statement that it has only manufactured 50,000 doses, though it plans to have 300,000 available within a few months. That is roughly 1 dose for every 1,100 Americans.

How does dexamethasone work, and does it have side effects?

Dexamethasone works by suppressing the extreme inflammatory reaction Covid-19 patients can have to the virus. Research has shown benefit in patients who are receiving oxygen or on mechanical ventilation. Typically, the steroid drug is prescribed to patients whose blood-oxygen levels are persistently low and require continuous supplemental oxygen, doctors say.

At the same time, doctors say dexamethasone can have extreme effects on mood, memory and thinking, including triggering feelings of euphoria and low-grade mania. People on dexamethasone may also have issues with cognition and decision-making, they say.

Daniel Griffin, chief of infectious diseases for ProHealth Care New York, said he tells patients not to make big, life-changing decisions when they are on steroid therapy.

“There are well-known negative impacts on judgment and memory," he said. “People may feel super confident and make reckless decisions."

Doctors say a typical course of dexamethasone is 10 days, and patients can continue taking it orally after being discharged from a hospital.

What is remdesivir and what are its potential benefits and side effects?

Remdesivir, made by Gilead Sciences Inc., is an antiviral medication that stops the virus from spreading in the body during an infection. It was cleared by the U.S. Food and Drug Administration for emergency use in hospitalized patients with Covid-19 after researchers reported it cut down the recovery times of hospitalized patients. It is now a standard course of treatment in hospitalized Covid-19 patients.

Liver and liver toxicity can be a side effect, doctors say, so it is important to monitor the liver and kidney function of patients who are receiving it.

How does Regeneron’s monoclonal antibody drug work? Are there side effects?

Regeneron’s REGN-COV2 is part of a class of medicines called monoclonal antibodies, developed in laboratories to mimic the naturally occurring antibodies that the immune system produces to fight off pathogens, such as viruses. Early research on the drug has shown encouraging results in treating patients who aren’t hospitalized.

Antibody therapy is meant to buy the body time to produce the arsenal of molecular defenses needed to fight the virus off on its own, researchers working on other antibody-based therapies said. If the body doesn’t produce its own, the person isn’t immune, infectious-disease experts said.

Regeneron’s therapy hasn’t been shown to have major side effects in most people. “Antibody infusions in general are pretty safe and well tolerated," said UCSF’s Dr. Chin-Hong.

How long would someone on the president’s treatment regimen be contagious?

It is hard to say because very few people, if any, have received the president’s exact treatment plan. But according to the Centers for Disease Control and Prevention, people with mild to moderate Covid-19 remain infectious up to 10 days after symptom onset. But those with more severe disease could remain infectious for up to 20 days, the agency says. Severe cases are defined as those who need supplemental oxygen, Dr. Griffin and others said. Mr. Trump got supplemental oxygen as part of his Covid-19 care.

It is possible, however, that mild-to-moderately ill people on steroids or other immunosuppressive drugs could have persistent viral shedding for longer than the CDC’s ten-day guidelines for such patients, said Dr. Chin-Hong. “Steroids affect your regular immune system’s ability to fight the virus. People on steroids could have a longer period of viral replication."

On Wednesday, the president’s doctor said Mr. Trump’s coronavirus antibodies levels were high.

What can an antibody test after antibody therapy tell you?

Results from an antibody test after receiving a dose of synthetic antibodies will show that a patient has antibodies, said Johns Hopkins infectious disease specialist Arturo Casadevall.

What proportion of those antibodies are natural or from the treatment can be tricky to decipher, Dr. Casadevall and others said. There are tests that can differentiate between antibodies given as therapy and those the body produces on its own based on what parts of the virus the antibodies attach to, he said. But not all tests do that, and Dr. Conley didn’t specify which type of test Mr. Trump got.

“Given the volume of IgG antibodies delivered in our therapy, and the timing of these tests, it is likely that the second test is detecting [Regeneron] antibodies," Regeneron said in a statement. IgG refers to a class of antibodies.

Can treatment with antibodies lead to long-term immunity?

After receiving antibody treatment, Mr. Trump said in a video posted to Twitter that he might be immune. But experts say that lab-grown antibodies don’t stick around indefinitely; their levels naturally wane with time, and their effectiveness at providing protection from infection or spreading the virus hasn’t been tested. That makes it critical for patients to continue to self-isolate, socially distance and wear masks, they said.

Most people start producing antibodies 10 to 12 days after infection, according to Carolina Lopez, who studies viral immunity at the Washington University School of Medicine in St. Louis. How long those last and what that means for long-term immunity are open questions researchers are trying to answer.

Are there possible risks to taking all three therapies at once?

Doctors say there is no reason to think dual treatment with Regeneron’s antibodies and remdesivier would lead to adverse effects. But it is possible that steroids could dampen the effect of Regeneron antibodies, said Dr. Chin-Hong, the UCSF infectious disease specialist. Steroids typically dampen immune system activity, he said, making the overall effect of the antibody treatment less predictable.

—Joseph Walker contributed to this article.

Write to Sarah Toy at sarah.toy@wsj.com and Daniela Hernandez at daniela.hernandez@wsj.com

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