Falling off the cliff: Experts say Trumps quick move to hospital could be sign of serious COVID illness – msnNOW

President Donald Trump was taken to Walter Reed hospital Friday evening after being diagnosed with COVID-19 late last night. For many patients, being hospitalized indicates they are on the edge of falling seriously ill, doctors say.

“If he went from being on the campaign trail to feeling sick yesterday to having a fever and now being hospitalized, I would be worried about him as a patient,” said Dr. Peter Chin-Hong, who has treated dozens of COVID-19 patients but isn’t privy to the President’s condition. “Hospitalization typically indicates a higher level of disease.”

White House press secretary Kayleigh McEnany said Friday the president “remains in good spirits and has mild symptoms.” 

“Out of an abundance of caution, and at the recommendation of his physician and medical experts, the President will be working from the presidential offices at Walter Reed for the next few days,” she said.

It’s impossible to predict the outcome for a patient hospitalized with COVID-19 because the disease varies so much by age group, demographics and geography, said Dr. Seth Cohen, director of infection prevention and control at the University of Washington Medical School.

“We see patients who start off with very mild infection early on but after a few days they can develop severe illnesses very quickly. It can be unpredictable what the trajectory of the illness will be at that point,” said Cohen, who has treated many COVID-19 patients. 

If he had a patient in their 70s who was obese and newly diagnosed with COVID-19, he would give them a finger pulse oximeter to measure their oxygen level and have a nurse check on them daily.

“If there were any indication they were experiencing shortness of breath, chest pain or worsening cough, we would immediately send them to the emergency room for evaluation,” he said. 

Amesh Adalja, a senior scholar at Johns Hopkins University Center for Health Security, said White House medical staff likely wanted to closely monitor Trump’s vital signs and recommend appropriate care.

A hospitalization “would suggest they would need more aggressive monitoring, bloodwork or intravenous fluids,” said Adalja, an infectious disease and emergency medicine expert. “Or possibly the use of an experimental therapy that might require a hospital setting to be administered in.”

Other doctors not involved in the president’s care said his age, weight and gender put him at high risk. At 74, the president is five times more likely to be hospitalized and 90 times more likely to die of COVID-19 than someone between the ages of 18 and 29, according to the CDC.   

Adults with obesity have triple the risk of hospitalization due to a COVID-19 infection, according to the CDC. This is in part because obesity is linked to impaired immune function and decreased lung capacity and reserve. 

Going to the hospital is a very significant event for most COVID-19 patients and generally occurs when they require oxygen, said Chin-Hong, a professor of medicine and infectious disease specialist at the University of California, San Francisco. 

“If you’re requiring oxygen, it indicates it’s more than just the virus, it indicates you’re dealing with inflammation from the virus,” he said. “That means you’re close to falling off the cliff.”

The progression into acute and dangerously severe COVID-19 can be very rapid and is something he’s seen in many patients.

 “It’s very, very sudden. Somebody might be on very little oxygen and then they suddenly start needing a lot of oxygen. Usually, it’s not a gradual progression,” Chin-Hong said. “The patient is kind of trucking along and then all of the sudden they go south. That’s why we talk about ‘falling off the cliff’ with COVID. You get wheeled to the ICU and you have lung injury most of the time.”

But it doesn’t make sense for Trump to have gotten sick enough to truly require hospitalization within a day of developing symptoms, said Dr. Ilan Schwartz, an infectious disease specialist at the University of Alberta in Edmonton, Canada.

“The timeline is out of keeping with this being a truly catastrophic event,” he said. “If they anticipate things might take a turn for the worse, they would want to be in a position where they’d have the appropriate facilities.”

Maybe the White House opted for an early trip to the hospital so Trump could be seen leaving while he was still relatively healthy, rather than visibly struggling, said Dr. Armand Dorian, chief medical officer at USC Verdugo Hills Hospital, north of Los Angeles.

“The last thing you want to do is be wheeling him out of the White House. Then we’re really in trouble,” Dorian said. He added Trump’s doctors also may have wanted access to more screening tools, like CT scans that might not be available in the White House.

Rather than taking Trump to the hospital, he might have been better off relaxing at home, said Dr. Eric Topol, founder and director of the Scripps Research Translational Institute, in La Jolla, California.

“People do better normally in the situation he’s in in the comfort of their own bedroom,” said Topol, a cardiologist. “It makes you think there was another reason (for taking him to the hospital), but this is so difficult to interpret.”

Contact Elizabeth Weise at eweise@usatoday.com and Karen Weintraub at kweintraub@usatoday.com.

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