President Donald Trump’s physician, Sean Conley, issued the latest notice about his COVID-19 patient’s progress on Wednesday with a positive update: The president’s lab results from Monday indicated that he had “detectable levels” of antibodies in his blood.
“The president this morning says, ‘I feel great!'” Conley’s statement said.
But doctors and scientists have since pointed out that the president having detectable antibodies could be meaningless, since he was administered a very high dose of an experimental antibody treatment on Friday.
“It’s meaningless, and it’s deceptive to present it like it isn’t,” Eric Topol, a cardiologist and clinical trial expert at the Scripps Research Translational Institute, told BuzzFeed News. “Why would you test for antibodies when you’ve given someone such a high dose of antibodies? That wouldn’t have been a good test to do. I don’t know how much it cost them, but they should get their money back.”
“My response after I read that is I am sure he does have detectable antibodies — because he was just given a massive infusion of antibodies by his own doctor. So I would be shocked if he didn’t,” said Megan Ranney, associate professor of emergency medicine and public health at Brown University.
On Friday, Conley reported that Trump received 8 grams of a two-antibody cocktail made by the biotechnology company Regeneron. The cocktail, which remains an experimental treatment, is comprised of a type of antibody called immunoglobulin G (or IgG) typically produced in the later course of an infection. The president was also given two other drugs, the antiviral drug remdesivir on Friday, and the steroid dexamethasone on Saturday, according to doctors.
The Regeneron synthetic antibodies are “the same IgG antibodies that patients make on their own,” Topol said. “They’ve basically been cloned. But these are the powerful ones — not the junk or ornamental ones. These are the most potent neutralizing antibodies.”
Patients typically start producing IgG antibodies from 7 to 10 days after infection, while studies have suggested that in rarer cases, people can develop IgG antibodies as early as 2 to 4 days after symptoms first appear.
It is possible that the White House administered a type of antibody test that could distinguish between the antibodies produced by Trump’s immune system and the ones administered via Regeneron’s experimental antibody cocktail, said Angela Rasmussen, a virologist at Columbia University. The White House did not disclose what type of test it used.
But on Wednesday afternoon, Regeneron released a statement saying that the antibodies detected were most likely from their treatment: “Most of the standard assays for IgG would not distinguish between endogenous (self-made) antibodies and the ones delivered by our therapy. However, 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 REGN-COV2 antibodies.”
“There’s a good chance they are” from the antibody cocktail, said Rasmussen. “My main takeaway is suspicion. The president’s physician has been releasing information selectively, and has stated that he tries to put a positive spin on it.” She added, “They have not released other information relevant to his condition, including the results of his chest scans or his viral loads or any other lab results.”
Conley’s statement added that Trump’s “physical exam and vital signs, including oxygen saturation and respiratory rate, all remain stable and in normal range. He’s now been fever-free for more than 4 days, symptom-free for over 24 hours, and has not needed nor received any supplemental oxygen since initial hospitalization,” the physician said.
But both doctors that BuzzFeed News spoke with warned that the president’s immune response will be important to monitor as he approaches 7 to 10 days after he developed the infection, a dangerous period when a small subset of COVID-19 patients suddenly get very sick after their immune systems go into overdrive, causing organ failure and possible death.
“The fact that he remains fever-free and feels great are just as likely to be effects of the dexamethasone as they are to be signs that his illness is improving,” Ranney said. “But the fact that someone has done well up until this point does not necessarily imply that they will continue to do well. We know that this seven-to-10-day period is when we see the immune system go wild, severe lung problems, strokes, and clotting problems — all of these really well-established serious clinical effects of COVID.”
Both doctors said that the latest statement from Trump’s physician indicated a continuing lack of transparency that was troubling.
“It’s the rose-colored glasses view of how the patient is doing each day. We don’t get the truth,” said Topol. “In his press conferences, there was deception and obfuscation and evasiveness — this one is just fallacy.”