I'm a Doctor and Here's What's Next for Trump
Yesterday, we learned that the President and the First Lady had tested positive for COVID-19. By the end of the day, there were images of the President lifting off on Marine 1 to be brought to Walter Reed Medical Center in Bethesda, Maryland for treatment.
As an Emergency Physician, I have taken care of patients across the spectrum of severity from COVID-19. Ranging from completely asymptomatic, all the way to the Intensive Care Unit of treatment and unfortunately sometimes death, this disease affects people very differently. Here is what the President can expect as he is treated in the hospital for COVID-19. Read on, and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.
Vital Sign Monitoring
Patients who are admitted for COVID-19 are connected to a monitor that allows for the medical team to receive ongoing stats about their heart rate, blood pressure, and oxygenation levels. With any virus or infection, the heart rate can be elevated due to dehydration, fever, and/or stress from the virus itself. Blood pressure must also be monitored, as decreasing blood pressure can be a sign that the infection is worsening.
Patients with COVID-19 have been found to have severely low blood oxygen levels. A team at Mount Sinai in New York City has found an explanation for this. COVID-19 causes a breakdown of the blood vessels in the lungs, allowing blood to flow back to the body without getting oxygenated. Patients sometimes need oxygen administered into the nose, increasing the amount of oxygen in the air they breathe. In some instances, patients need to have a tube placed into the trachea to deliver oxygen directly to the lungs.
Intravenous fluids are very common for patients who are admitted to the hospital. It is imperative to not be dehydrated when battling any virus, as dehydration can prompt organs, such as the kidneys, to stop functioning. Viruses can lead to severe reactions within the body which causes the normal fluids within the body to leak into the skin and other tissues. This can reduce blood pressure, which can negatively affect organs. The supplemental fluids are given to help maintain normal blood pressure and keep organs functioning appropriately.
One of the major determinants of severe outcomes of COVID-19 is the X-ray appearance of pneumonia in both lungs. The President will have X-rays taken throughout his stay in the hospital to monitor for possible worsening symptoms.
Although not a direct evaluation of worsening disease, the President will have many different lab tests taken while in the hospital. There are some labs that have been found to be indicators of worsening disease. These labs can help the President's team determine if the severe inflammation that is known to occur with COVID-19 is affecting him.
Vitamin D is an important vitamin that we receive from the sun and fortified milk products. It is an important vitamin in maintaining normal levels of calcium and magnesium which improves bone health. It is also an integral part of the immune system as there are proteins that are formed by Vitamin D that are thought to help the body combat viruses. Supplemental Vitamin D therapy, as in the President's case, is used to help induce the body's own virus-fighting properties.
For most people, supplemental zinc is not thought of as a treatment for any infection, but rather as an additive in cough drops. Zinc is immensely important in the body's ability to fight infection, however. Zinc is necessary for many enzymes within the body that help with the growth of cells, as well as with the maintenance of the DNA/RNA. With increased zinc in the body, there is an increase in certain types of proteins that help the body fight viral infections.
Although a medication used in the treatment of heartburn, there is some evidence that famotidine is helpful in the treatment of COVID-19. Patients who were given famotidine had a reduction in overall mortality in comparison to those who had not taken the medication. Although the mechanism of this is not yet known, a current hypothesis is that it reduces the body's response to the virus. It is known that patients that have bad outcomes from COVID-19 have experienced a process called "cytokine storm". Minimizing this process in the body has been shown to diminishing the negative effects of COVID-19.
If the President has worsening COVID-19 symptoms, such as decreasing oxygenation, he may be placed on Remdesivir. This medication, which has been granted emergency use authorization by the FDA, has been found to shorten the hospital stay of many patients with COVID-19. Although researchers are still trying to determine exactly why this medication works on effected COVID-19 patients, it is thought to keep the virus from replicating.
These anti-inflammatory medications must be used appropriately in any infection. Steroids can reduce the body's ability to fight acute infections, but at the same time, they can reduce the inflammation within the body. If appropriate, steroids can be used to help the lungs function better by reducing the inflammation within them. As for yourself: To get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.