After three nights in the hospital, President Donald Trump has tried to reassure the public that he is strong, healthy, and, somehow, even better than he was before his COVID-19 diagnosis. “Feeling really good!” he tweeted Monday as he was preparing to return to the White House. “Don’t be afraid of Covid. Don’t let it dominate your life. We have developed, under the Trump Administration, some really great drugs & knowledge. I feel better than I did 20 years ago!” He posed, mask-less, for a photo-op, and on Tuesday morning he fired off more tweets telling Americans not to worry about COVID.
Despite Trump’s insistence that he feels “better than I did 20 years ago,” it’s clear he had a rough weekend. Trump’s doctor acknowledged that the president had needed supplemental oxygen and detailed a number of treatments that called into question the assurances that Trump’s case was a mild one.
Here’s what we know about the president’s medications.
Regeneron cocktail
On Friday, Trump’s doctor told reporters that the president had started an experimental antibody cocktail produced by Regeneron. The cocktail, a combination of two antibodies, is meant to bolster the body’s ability to fight the virus. But the treatment has not been authorized even for emergency use by the Food and Drug Administration. Instead, Trump’s medical staff petitioned the company for permission to use the drug as a compassionate use case. (In some circumstances, drugs that have not been cleared by the FDA are allowed to be used in special cases when all other treatment options have failed.) In this instance, however, it seems likely that the president’s doctors were eager to throw everything they had at his case and were able to use Trump’s office to get around the normal standards. Typically, Regeneron avoids agreeing to too many compassionate use requests, as the drug is in limited supply.
The cocktail has been in clinical trials since June, and according to the company, the trial has indicated that it is safe to take. The trial has had just 275 non-hospitalized patients as volunteers, but according to Regeneron, those who took the drug, and particularly those who did not produce their own antibodies during the beginning of their illness, recovered more quickly. The study has not yet been peer-reviewed, and there is little information about the drug’s effects or how it interacts with other medications.
Remdesivir
The other experimental drug Trump has been placed on is an antiviral produced by Gilead Sciences. Like the Regeneron cocktail, Remdesivir is meant to hasten recovery, but it is more typically used for more serious cases. The drug, originally developed to treat Ebola and repurposed for the coronavirus, is currently in a phase 3 clinical trial involving 600 patients. That study has found that it helps the moderately ill patients who develop pneumonia or otherwise need oxygen or ventilation. The FDA first approved the drug to be used as an emergency measure for severe COVID cases in May. Later, it amended the authorization to include all patients who need hospitalization and emergency treatment. According to the FDA, possible side effects include low blood pressure, shortness of breath, vomiting, sweating, and swelling of the lips, face, or throat. It’s not known how it would interact with the Regeneron cocktail. Trump began a five-day course of the Remdesivir on Friday night.
Dexamethasone
While the other two drugs may be experimental, it’s the regular and inexpensive corticosteroid that has been raising the most eyebrows. Trump was given the Dexamethasone on Saturday when his oxygen levels dropped. Dexamethasone, which reduces inflammation, would typically only be given to a patient if they needed oxygen or ventilation, and the National Institutes of Health recommends against using it in anything other than serious cases, as steroids can limit a body’s immune response. “Generally you start the dexamethasone when you’re starting to worry that they’re heading down the wrong path,” one doctor told CNN. The president’s doctor said that, “We decided that in this case the potential benefits early on in the course probably outweighed the risks.” It’s unclear if this means that Trump’s case was much worse than his doctors publicly let on or if his doctors were overly zealous in their treatment.
Side effects can include: aggression, agitation, anxiety, blurred vision, dizziness, irritability, mental depression, mood changes, nervousness, and issues breathing, speaking, and walking.
Zinc
There is no evidence that zinc can help the body fight off the coronavirus. Zinc can help the immune system resist bacteria and viruses, and people often take zinc to help with the common cold. Some have theorized that patients with lower levels of zinc do worse fighting off the coronavirus. Still, there is no evidence showing zinc as a supplement helps. The use of zinc fits with the other measures, though, as it seems the doctors were throwing every possible treatment they had at the president.
Vitamin D
As with the zinc, some people believe that having a vitamin D deficiency can make it harder to fight off the virus.
Pepcid
The White House said the president had taken famotidine, an over-the-counter antihistamine and antacid used to treat ulcers, heartburn, and acid reflux. Pepcid is safe to take, and some studies have suggested it might help with COVID-19. It’s also possible it does nothing.
Aspirin
Trump’s doctor has said that the president was taking a daily aspirin. It’s not clear if he was already taking one to reduce the risk of a blood clot and heart attack. COVID-19 may put patients at higher risk for blood clots, so this appears to be a standard measure. Aspirin could also help with pain or fever.
Melatonin
It’s still unclear if the sleep aid melatonin can help COVID patients, but some studies suggest that obese patients may benefit from it.
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