Trump’s age, sex, weight make severe COVID-19 more likely

President Trump may be the leader of the free world, but as far as the coronavirus is concerned, he is a 74-year-old male with obesity.

Each of those three attributes — his age, sex and weight status — increases his risk of developing a severe case of COVID-19.

The president announced on Twitter early Friday that both he and First Lady Melania Trump had tested positive for coronavirus infections. He did not say whether he had experienced any symptoms of COVID-19, the disease the virus causes, but he did note that he and his wife planned to “begin our quarantine and recovery process immediately.”

Although many people who test positive for the coronavirus never develop any outward sign of infection, odds are that the president will experience symptoms of some kind. Roughly half of all COVID-19 patients in the U.S. experience a a cough, according to data from the Centers for Disease Control and Prevention. Other common symptoms include headache, muscle pain and shortness of breath.

Should Trump’s infection progress to a case of COVID-19, there are reasons to be concerned about the potential severity of his illness.

The odds of a severe case of COVID-19 — one that requires hospitalization, intensive care or breathing assistance — rise steadily with age, according to the CDC. Compared to young adults between the ages of 18 and 29, a person between the ages of 65 and 74 is five times more likely to be admitted to a hospital and 90 times more likely to die of the disease.

Other CDC data indicate that, among COVID-19 patients in their 70s, the death rate for those who were in good health at the time of their infection was 10%. For those already dealing with a medical condition, the death rate was three times as great: 32%.

Since the early days of the pandemic, researchers have observed that COVID-19 patients who are obese fare worse than those who are not.

According to a report in June from Trump’s physician, Dr. Sean Conley, the president is 6 feet, 3 inches tall and weighs 244 pounds. That means his body mass index, or BMI, is 30.5, just over the threshold for obesity. (He’s got plenty of company: 42.4% of U.S. adults are obese, the CDC says.)

It’s not clear why obesity may make a COVID-19 patient sicker. Doctors suspect that, as a respiratory illness, it may intensify the breathing difficulties common in people with obesity. Another theory is that obesity predisposes a person’s immune system to overreact to the coronavirus, triggering a dangerous “cytokine storm” that destroys tissues without stopping the infection.

Whatever the reason, one study of COVID-19 patients who came to emergency rooms found that those who were under the age of 60 and had a BMI at the low end of the obesity range were twice as likely as non-obese patients to be admitted to the hospital rather than be sent home. They were also 80% more likely to spend time in intensive care.

However, that same study found no association between obesity and COVID-19 severity among patients 65 and older.