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And he received a five-day course of the antiviral drug remdesivir. Medical experts at the time believed that his medication course was a clear signal of significant issues related to his lungs.

In news conferences outside the hospital that weekend, Dr. Conley offered data that made it appear his patient was recovering quickly. He noted that Mr. Trump had fared well on a spirometry test, which measures lung capacity. “He’s maxing it out,” Dr. Conley said. “He’s doing great.”

Medical experts say a spirometry test is virtually meaningless with Covid-19 patients.

When Mark Meadows, the White House chief of staff, tried to surreptitiously tell reporters that the situation was more dire, Mr. Trump erupted in anger, according to people who spoke with him.

On Sunday, Oct. 4, Dr. Conley acknowledged that he had given a rosy version of Mr. Trump’s condition.

“I was trying to reflect the upbeat attitude that the team, the president, his course of illness has had,” he said. “I didn’t want to give any information that might steer the course of illness in another direction, and in doing so, you know, it came off that we were trying to hide something, which wasn’t necessarily true.”

Mr. Trump’s medical team said that on that Friday, he had a “high fever” and that his oxygen level dropped, requiring him to be administered oxygen. Mr. Trump’s oxygen level dropped again on Saturday.

Mr. Trump appeared to still be struggling with the disease when he returned to the White House, where he stationed himself on a balcony in a choreographed scene, tearing his mask off and saluting his helicopter. Doctors at the time noted how Mr. Trump used his neck muscles to help him breathe in those moments, a classic sign that someone’s lungs are not taking in enough oxygen.