President Trump has received at least three effective drugs since announcing he tested positive for COVID-19 Thursday night: Regeneron's cocktail of laboratory-made antibodies, the antiviral remdesivir, and the steroid dexamethasone.
Two of these drugs are still experimental for the treatment of COVID-19 and have received emergency approval from the Food and Drug Administration (FDA).
And the White House doctor, Dr. Sean Conley, admitted Monday he would not disclose every single drug the president is currently receiving (citing laws protecting the privacy of HIPAA patients, suggesting Trump himself is giving Dr. Conley permission has to disclose some of his drugs, but not all of them).
Remdesivir, dexamethasone, and the antibody cocktail are all in ongoing trials – but it's unclear whether anyone other than the U.S. Commander in Chief has ever been treated with all three.
These three drugs are "as far as we know (about the President's regimen) – but I found it all really confusing based on the reports," said Dr. Mark Poznansky, an infectious disease specialist at Massachusetts General Hospital, told DailyMail.com.
When asked if there was a precedent for treating a COVID-19 patient with all three drugs, Dr. Poznansky: "No."
"But the individual decisions are based on the individual patient and all bets are void when dealing with the President, the Commander in Chief," he added.
"The implication is that doctors believe the risk of using these is outweighed by the potential benefits."
And while we have some clarity about the possible side effects of each drug, it is a mystery how they might interact, "because they just haven't been used often enough … we don't know about the combination," Dr. Said Poznansky.
But even on their own, the side effects of these drugs could be of particular concern to the President as the steroid can cause mood swings, confusion, and aggression.
The drugs he's been treated with and their possible side effects are:
REGENERON'S EXPERIMENTAL ANTIBODY COCKTAIL MEDICINAL
IF HE HAS IT: Trump received a single dose of 8 grams of Regeneron's cocktail of laboratory-made antibodies on Friday.
WHAT IT DOES: REGN-COV2 is a combination of two laboratory-made versions of antibodies that prevent coronavirus from entering cells.
One of the antibodies in the "Cocktail" is based on an antibody that mice produce in response to the coronavirus, while the other is based on an antibody that was isolated from one of the first US COVID-19 patients.
The hope is that treatment will lower the viral load, prevent the body from overrun and mess up the immune system, and prevent the infection from getting serious.
WHAT THE DATA SAY: REGN-COV2 is still in the early stages of study, but initial data from its clinical trial showed that it drastically reduced viral loads within a week and increased recovery time in patients who were not sick enough to be hospitalized halved.
Regeneron has not yet studied the drug in seriously ill patients.
THE POSSIBLE SIDE EFFECTS: The main concern is that these types of treatment occasionally induce "antibody-dependent amplification," which means that the therapeutic intended will actually help the virus enter cells.
So far, the studies do not suggest that REGN-COV2 causes this phenomenon.
Antibody treatments can also cause allergic reactions such as anaphylaxis, as well as fever, chills, nausea, diarrhea, weakness, headache, and low blood pressure.
REMDESIVIR, GILEAD'S ANTIVIRAL MEDICINAL
IF HE HAS IT: President Trump received his first dose of a five-day treatment course Friday night after being transferred from the White House to Walter Reed National Medical Center.
He has since received his second and third doses of the drug.
WHAT IT DOES: Remdesivir is an antiviral therapy that was originally developed to treat Ebola.
Scientists aren't entirely sure why, but it helps prevent the coronavirus from making more copies of itself.
WHAT THE DATA SAY: Late clinical trials with remdesivir found that patients treated with the drug were more likely to recover within 11 days than those who did not receive the drug.
Their chances of survival were 40 percent better. In May, the drug was the first to receive emergency approval from the FDA for the treatment of critically ill patients. This approval has now been extended to all hospital patients.
THE POSSIBLE SIDE EFFECTS: It can cause nausea, vomiting, chills, sweating, or drowsiness. The drug can also affect liver function, which means patients must be closely monitored.
There was some evidence that Trump's liver and kidney function wasn't optimal last night, but Dr. Conley said Monday the president was just "dehydrated".
DEXAMETHASONE, THE $ 6 STEROID WITH COMMON PSYCHIATRIC SIDE EFFECTS
When he got it: The president received a dose of dexamethasone on Saturday after developing a high fever and twice his blood oxygen levels falling below 94 percent.
WHAT IT DOES: Dexamethasone is a cheap steroid that is known to suppress inflammation. It is already approved for use under other conditions in the United States.
WHAT THE DATA SAY: Although it hasn't received an emergency approval in the U.S., dexamethasone is the most promising treatment for coronavirus to date.
In a large UK study, the steroid reduced the risk of death for patients sick enough to need breathing equipment by 36 percent by 18 percent for patients who only need supplemental oxygen.
However, it appeared harmful in earlier stages or in milder cases of illness: 18 percent of drug users died versus 14 percent of usual caregivers.
Because of this, many doctors were alarmed that President Trump was being treated with the drug because its use indicated that he was either very ill or that doctors were taking a risk giving it to him early on.
THE POSSIBLE SIDE EFFECTS: The steroid is strong and can cause swelling, headache, stomach pain, nausea, weakness, dizziness, trouble sleeping, blurred vision, skin problems, severe allergic reactions including mood swings.
These mood swings include aggression, agitation, and confusion.
"Steroids are always very dangerous drugs," said Dr. Edward Jones-Lopez, an infectious disease specialist at the University of Southern California in Los Angeles, told Reuters.
& # 39; This is why it (dexamethasone) is used in severe to critical patients … There may be neuropsychiatric side effects. These are drugs that we use very, very carefully. & # 39;
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