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Prospect of Trump’s early hospital discharge mystifies doctors

The talk of the president’s release from Walter Reed National Military Medical Center came as Conley and two other physicians treating Trump gave an upbeat but incomplete characterization of his condition. Outside doctors said they were mystified by what they said was an inconsistent portrayal of the president’s illness as relatively mild despite the aggressive mix of treatments he is getting.

The president’s medical team was at times cryptic: Asked whether CT scans showed any signs of pneumonia or lung damage, Conley replied, “Yeah, so we’re tracking all of that. There’s some expected findings, but nothing of any major clinical concern.” He declined to elaborate. At another point, Sean Dooley, a pulmonary critical care doctor, said the president’s “cardiac, liver and kidney function demonstrates continued normal findings, or improving findings.” He did not disclose which of those had been subpar.

“My impression is they are telling us everything that is of good news and limiting everything that is not perfect,” said Rochelle Walensky, chief of infectious diseases at Massachusetts General Hospital.

Robert Wachter, chairman of the University of California at San Francisco’s department of medicine, said any patient of his with Trump’s symptoms and treatment who wanted to be discharged from the hospital three days after their admission would need to sign out against doctors’ orders because it would be so ill-advised.

“For someone sick enough to have required remdesivir and dexamethasone, I can’t think of a situation in which a patient would be okay to leave on day three, even with the White House’s medical capacity,” Wachter said.

“Absolutely not,” William Schaffner, a professor of infectious diseases at Vanderbilt University’s medical school, said of the idea of sending Trump back to the White House on Monday.

“I will bet dollars to doughnuts it’s the president and his political aides who are talking about discharge, not his doctors,” Schaffner added.

Medical consensus has emerged that covid-19 patients are especially vulnerable for a period of a week to 10 days after their first symptoms. Some patients who seem relatively healthy suddenly deteriorate, either because of the virus itself or an excessive immune response that can cause damage to several organs, including the heart.

A multitude of possible cardiac complications have also been associated with covid-19, the most prominent of which involves a hardening of the walls of the heart that makes it difficult to pump blood and can lead to heart failure.

“People can be doing okay, but it can get a rocky very quickly,” said Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security and an infectious-disease specialist at the University of Pittsburgh.

Underscoring the concerns is the fact that President Trump may be the first patient — he is certainly among the first — to receive an unusual combination of three strong treatments, with a handful of supplements and an over-the-counter drug sprinkled in.

“He’s gotten kitchen-sink therapy,” said Walensky, of Massachusetts General. She noted that when dexamethasone was tested in clinical trials earlier