WSJ : Trump Remains Hospitalized as Doctors Offer Mixed Signals on President’s H

Trump Remains Hospitalized as Doctors Offer Mixed Signals on President’s Health
President briefly left quarantine to greet supporters despite taking a steroid that has been recommended for serious cases of Covid-19

WASHINGTON—President Trump remained hospitalized with Covid-19 on Monday after seeking to project confidence and vigor over the weekend, as his doctors offered conflicting signals about how he is faring with the unpredictable illness.

The president’s physicians are expected to deliver another update on his condition on Monday. Doctors said Sunday that the president’s vital signs were stable, he wasn’t experiencing shortness of breath, and he has been fever-free since Friday.

Doctors haven’t said when they plan to discharge Mr. Trump, after raising the possibility that he could return to the White House as soon as Monday. But there were signals that Mr. Trump’s condition remained serious. His blood-oxygen levels dropped as recently as Saturday and he was being treated with dexamethasone, a steroid that has been given to Covid-19 patients who are seriously ill.

Experts have said some patients experience worsening symptoms in the second week of having the virus.

Doctors on Sunday also sought to clarify past statements about his condition that were incomplete or contradictory. Dr. Sean Conley, the president’s physician, said at a news conference on Sunday at Walter Reed National Military Medical Center that Mr. Trump’s condition “continues to improve.” But he also said Mr. Trump’s symptoms had been serious, adding that he tried to provide an “upbeat” assessment in a Saturday briefing in which he played down the president’s condition.

Mr. Trump, for his part, tried to show the public that he hasn’t been incapacitated by the virus. In a video posted to his Twitter account on Sunday, he said his illness had given him an education in the risks of the coronavirus, adding, “I get it and I understand it.”

Shortly after posting the video, the president left Walter Reed in a black SUV to greet supporters gathered outside the hospital grounds. While the White House said the excursion was approved by the president’s medical team, it wasn’t in line with government Covid guidelines for quarantining, designed to avoid infecting other people.

The president’s diagnosis and hospitalization have thrust his White House into turmoil, complicated plans for his Supreme Court nominee and created fresh uncertainty for his presidential campaign just weeks before Election Day.

Vice President Mike Pence was scheduled to depart for Salt Lake City on Monday ahead of the vice presidential debate set for Wednesday. The debate has taken on new importance after Mr. Trump’s hospitalization elevated the vice president’s role in the campaign.

Some in the Trump administration have privately expressed frustration over senior officials’ handling of the coronavirus outbreak, directing some of their anger at White House chief of staff Mark Meadows, according to people familiar with the matter. Aides said they felt left in the dark about the risks and the positive cases at the White House.

Mr. Meadows has also come under fire from Mr. Trump, who faulted his chief of staff for what the president viewed as a botched communications effort about his condition, some of the people said.

The president and others in the White House initially sought to shield the public from the extent of the outbreak. Mr. Trump asked one adviser not to disclose results of the person’s own positive test, according to a person familiar with the conversation. And the president didn’t disclose a positive result from a rapid test for Covid-19 on Thursday while awaiting the findings from a more thorough coronavirus screening, according to people familiar with the matter.

Mr. Trump has told aides that he is eager to return to the White House, one of the people said. Asked what the president’s treatment might look like at the White House, communications director Alyssa Farah said Sunday that there was a “fully operating medical team” at the White House. “There’s a lot we can do from the White House, the residence,” she said.

Offering additional details about the president’s condition Sunday, Dr. Conley said the president had experienced two drops in oxygen saturation levels. Late Friday morning, before he was admitted to the hospital, it dropped below 94%, and he was given supplemental oxygen for about an hour. He experienced a high fever at the time, Dr. Conley said, without specifying his temperature. The 74-year-old president’s oxygen level also dropped on Saturday, this time to about 93%, his physicians said.

A mildly obese patient of Mr. Trump’s age with oxygen saturation below 94% would typically be given supplemental oxygen for a half or full day and would be monitored to see if levels return to normal, said Peter Chin-Hong, an infectious-disease specialist and professor of medicine at the University of California San Francisco. Normal blood-oxygen saturation levels range between 95% and 100%.

Dr. Conley didn’t offer a clear answer when pressed about whether Mr. Trump required supplemental oxygen on Saturday, saying: “I’d have to check with the nursing staff. I don’t think—if he did, it was very limited.” He also declined to elaborate on what the doctors’ examinations of the president’s lungs had found. The White House didn’t respond to follow-up inquiries.

The president’s doctors also said he had been treated with dexamethasone. The generic drug is a commonly used steroid that has been shown to help severely ill Covid-19 patients. The World Health Organization issued updated guidelines last month recommending steroid treatment in patients with severe or critical Covid-19, including patients with difficulty breathing and those requiring oxygen support with a ventilator or face mask. The WHO recommended not to use steroids in treating patients with nonsevere Covid-19.

Mr. Trump also has also taken Regeneron Pharmaceuticals Inc.’s experimental antibody drug cocktail, and he is currently on a five-day course of the antiviral drug remdesivir, which has been authorized for treatment of hospitalized Covid-19 patients.