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White House physician Sean P. Conley gave an update on President Trump’s health from Walter Reed hospital, saying he was “doing very well.”

USA TODAY

WASHINGTON – President Donald Trump’s condition after receiving a diagnosis of COVID-19 was “very concerning,” a White House official told the Associated Press, a sober assessment that raised new questions about the extent of the president’s illness. 

The president’s vitals over the past daywere “very concerning” and the next 48 hours will be critical for his care, White House chief of staff Mark Meadows told the Associated Press. 

The course of COVID-19 can be highly variable, but the next three to five days are likely to be crucial, physicians who have treated hundreds of coronavirus patients told USA TODAY.

Meadows’ assessment was more disquieting than the one offered Saturday by White House physician Sean Conley — who said the president was “doing very well” — the latest in a series of mixed messages from officials about the president’s condition since Trump tested positive for the virus.   

White House officials initially said Trump had a “mild” case of COVID-19after testing positive late Thursday and moving to the Walter Reed Medical Center on Friday evening. Trump disclosed the results in a tweet early Friday morning and was seen walking to Marine One that evening for the short helicopter journey to the hospital. 

Conley said Saturday the president had been fever free for 24 hours and was not receiving oxygen.Conley said Trump experienced a mild cough, nasal congestion and fatigue on Thursday, “all of which are now resolving and improving.”

Walter Reed referred questions about Conley’s briefing Saturday back to the White House.

Breaking a more than 12-hour silence on Twitter, Trump posted Saturday that he was “feeling well” and he praised the doctors, nurses and other staff at Walter Reed. He later tweeted encouragement to members of Congress to approve an economic stimulus for the pandemic. 

Doctors repeatedly said Trump, 74, was not on oxygen Saturday but did not answer specific questions about whether he had received it previously, though Trump’s medical team denied a report Friday that the president was having trouble breathing.  

“He’s not on oxygen right now,” Conley said, adding that Trump had an oxygen saturation level of 96%, within the normal range for a healthy person 

But Conley declined to rule out that Trump had received oxygen Friday before heading to the hospital and the Associated Press, citing an unnamed source, reported that oxygen had been administered in that period. 

White House officials declined to answer questions from USA TODAY about whether oxygen was administered.  

What to know about oxygen levels

Doctors monitor oxygen in blood as an indicator of whether there’s low oxygen levels, one of the problems that occurs with COVID-19.  

It’s not uncommon for people with COVID-19 to have intermittent oxygen needs, said Dr. Russell Buhr, a professor of pulmonary and critical care medicine at the University of California, Los Angeles. Early on in the course of the disease, the coronavirus can cause injury to the lungs by damaging the cells that allow oxygen to pass into the bloodstream.

“If those cells are damaged, we compensate by administering supplemental oxygen so the lungs are getting more oxygen than they would from the air in the room,” said Buhr, who has cared for over 100 coronavirus patients.

Patients hospitalized with COVID-19 tend to need a bit of oxygen when they first arrive at the hospital, often when they’ve already been sick at home for between three days and a week.

“Some of them get better at that point and recover. Some of them get worse,” said J. Randall Curtis, a professor of pulmonary and critical care medicine at the University of Washington in Seattle.

3 days in

In his opening remarks, Conley said Trump was “just 72 hours into the diagnosis now,” which drew considerable attention to the timeline of when the White House knew about the president’s condition.

If taken literally, 72 hours would put the president’s diagnosis to Wednesday morning, before he traveled to Minnesota for a rally Wednesday and a fundraiser in New Jersey on Thursday. Trump announced early Friday that he and first lady Melania Trump contracted the virus.

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President Donald Trump and first lady Melania Trump have tested positive for COVID-19 and “will begin our quarantine and recovery process immediately.”

USA TODAY

But a senior administration official speaking on the condition anonymity said that Conley was referring to the president being in his third day fighting the virus, with a diagnosis made late Thursday night, and symptoms continuing into Friday and Saturday.  Elsewhere during his remarks, Conley said the White House received confirmation of the president’s diagnosis late Thursday and he later issued a clarification saying he meant to say “day three.”

Asked why, specifically, Trump had been transferred to Walter Reed, Conley indicated it was out of an abundance of caution. 

“Because he’s the president of the United States,” Conley said. 

Conley said doctors were performing daily ultrasounds and lab work.

President Donald Trump walks off Marine One while arriving at Walter Reed Medical Center in Bethesda, Maryland on October 2, 2020. (Photo: BRENDAN SMIALOWSKI, AFP via Getty Images)

Soon after Trump arrived at the hospital, the White House released a memo from Conley indicating the president was starting remdesivir therapy. Conley said at that time that Trump was “resting comfortably.” 

Trump also received a single 8-gram dose of Regeneron’s polyclonal antibody cocktail as a precautionary measure, according to Conley. The antibody cocktail is being studied in four late-stage clinical trials and its safety and efficacy have not been fully evaluated by any regulatory authority, the company said on its page.

For more Trump COVID-19 updates, listen to the latest 5 Things podcast:

More: President Trump hospitalized at Walter Reed after testing positive for COVID-19

More: Woodrow Wilson downplayed the 1918 flu pandemic. Then, he got violently sick.

Trump himself has remained uncharacteristically out of view since announcing the diagnosis and White House officials sought to convey a sense of business-as-usual throughout the day Friday. On Saturday, officials announced that Trump had signed two resolutions appointing citizen regents to the board of the Smithsonian Institution. 

After remaining silent on Twitter for much of Friday, he posted a message at 11:30 p.m. EST saying that things were “going welI, I think!”

Contributing: Elizabeth Weise, Karen Weintraub, Courtney Subramanian  

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