Overweight, old and male: the reasons the risks to Trump are real

WHEN it comes to Donald Trump’s risk of becoming seriously ill with coronavirus, there are “known knowns” and there are “known unknowns”.

The US president is characteristically hyperbolic about his health, insisting he is “blessed with great genes” and “superb” mental abilities.

A letter from his personal doctor, Harold Bornstein, in 2015 described the presidential candidate’s health as “astonishingly excellent” adding that “Mr Trump will be the healthiest individual ever elected to the presidency”.

It later emerged that Mr Trump had dictated the report himself.

What is clear is that the president has several factors stacked against him including his age, weight and sex.

When all his details were entered into the US “19 and Me” coronavirus risk calculator, the president was found to have a 35 per cent risk of hospitalisation, an 11 per cent risk of needing intensive care and an eight per cent risk of death.

Here we explain why the virus could pose a real danger to the president:

Age

More than 200,000 people have now died in the United States, and undoubtedly the biggest risk factor is age.

At 74, Mr Trump is the oldest firstterm president in US history, and falls into an age bracket (65 to 74) which has seen 21 per cent of all US deaths.

The chance of death increases around 12-13 per cent each year, and doubles every five to six years. It means 20 years of ageing increases the risk by around 10-fold, which means that compared to a 20-year-old, an 80-year-old is 1,000 times more likely to die.

The US Centres for Disease Control and Prevention (CDC) reports that people aged 65 to 74 have a five times higher risk of hospital admission with coronavirus compared with those aged 18 to 29, and a 90 per cent higher risk of death.

Michael Head, the senior research fellow in global health, at the University of Southampton, said: “The president’s profile would classify him as vulnerable. He is aged 74 and reportedly overweight. Many people in their 70s will also have further co-morbidities that increase the risks of a more severe illness.”

Sex and ethnicity

It also does not help Mr Trump that he is a man. Overall, men are more likely to die from Covid-19 than women. Latest figures from the CDC show that so far in the US, around 104,896 men have died from coronavirus, compared with 89,191 women.

However, being white is less dangerous than being from a black, Asian or minority ethnic background.

People of Indian, Pakistani and Bangladeshi heritage are 20 per cent more likely to die if they catch coronavirus. Although black people are disproportionately impacted because they are more likely to catch the virus in the first place and be hospitalised, they are no more likely to die from it.

Weight

Obesity is also a major risk factor for severe Covid. The President weighs in at 17 stone 6lb ( 110.7kg) and is 6ft 3 inches tall, which means that he is clinically obese and has a Body Mass Index (BMI) of 30.3. The NHS recommends someone of Mr Trump’s height and build should lose 12lb to be healthy.

A review of studies by Public Health England (PHE) found a dramatic rise in the risk of hospital admission and death from Covid-19 for people who are overweight or obese.

One study that was analysed found that, compared with a normal BMI, being overweight increased the risk of admission to intensive care by about 50 per cent, rising to more than double the risk for those with a BMI of 30 to 35, and about a fourfold increased risk for those with a BMI over 35. However, the President plays golf and appears to walk quickly, which experts say is an indicator of good health. He is also known to only eat the toppings of his pizza for health reasons.

Naveed Sattar, professor of metabolic medicine, University of Glasgow, said “Donald Trump has some risk factors such as being male, older and overweight but if he has no chronic conditions and is reasonably active then these may offset or attenuate his risks so that he may recover swiftly from the infection.”

Underlying conditions

Although the president claims to have no underlying conditions, in Feb 2018, medical records released by the White House suggest that Mr Trump has a common form of heart disease.

He underwent a coronary calcium CAT scan as part of his routine physical exam and his score was 133. Anything over 100 indicates plaque is present and that the patient has heart disease.

At the time, doctors said that he may experience a heart attack in three to five years, but that the problem could be addressed with cholesterol-lowering drugs like statins, or lifestyle changes. It is not known if Mr Trump takes medication. He does not drink or smoke, which are also risk factors for severe Covid.

There are also concerns that the president could be suffering from a neurol ogical c ondition after s e veral incidences where he has appeared unsteady on his feet and his speech has appeared slurred.

Heart disease and neurological conditions are known to be a risk factor for severe Covid. Based on early US reports, 40 per cent of hospitalised Covid-19 patients had cardiovascular disease or cerebrovascular disease

If the president does have heart disease, his risk of being hospitalised from Covid would rise to 46 per cent, while his chance of needing intensive care would rise to 16 per cent. He would also have a one-in-10 risk of death.

Long Covid

However, even after recovery, there is the risk of “Long Covid”.

In September, researchers at North Bristol NHS Trust found that three quarters of virus patients treated at Bristol’s Southmead Hospital were experiencing problems three months later. Symptoms included breathlessness, excessive fatigue and muscle aches, leaving people struggling to wash, dress and return to work.

‘The president’s profile would classify him as vulnerable. He is aged 74 and reportedly overweight’

What about Melania?

Melania is younger – just 50 – has a healthier weight, and as a female, she is also at far less risk of becoming seriously ill. The 19 and Me calculator estimates that Melania has a 5 per cent risk of hospitalisation, just 1.3 per cent risk of needing intensive care treatment, and a risk of dying of 0.4 per cent.