Doctors declared Joe Biden, 80, healthy and “fit for duty” on Thursday after a physical examination that included removing a lesion from his chest and declaring him free of symptoms of long Covid after his bout last year with the virus.

“The president remains fit for duty, and fully executes all of his responsibilities without any exemptions or accommodations,” White House physician Kevin O’Connor said in a summary of the health exam.

The exam was closely watched as Biden prepares for his expected run for a second term in 2024. The summary said Biden did not have any “long Covid” symptoms and that his stiff gait has not worsened since his last exam in November 2021.

Biden said his physical went well. “Everything really went well … Thank God for small favors,” he told NBC News.

Biden’s three-hour session with doctors at Walter Reed National Military Medical Center in the Washington suburb of Bethesda, Maryland, was his second extensive exam since taking office in January 2021.

Biden takes the statin drug Crestor to keep his cholesterol levels low, an anticoagulant in response to atrial fibrillation that remains asymptomatic and medication to treaty seasonal allergies and acid reflux, the summary said.

Several small skin growths were moved from his face and head using liquid nitrogen and “one small lesion on the president’s chest was excised today and sent for traditional biopsy”, O’Connor said. The results are pending.

The summary found that Biden’s weight had dropped six pounds, from 184 pounds in 2021 to 178. His body mass index was at 24.1, compared with 25.0 in 2021, and his blood pressure was at 126/78, compared with 120/70 in 2021.

The summary made no mention of whether Biden underwent any cognitive tests sometimes given to people his age.

O’Connor said Biden’s back stiffness is a result of significant spinal arthritis.

“The president’s gait remains stiff, but has not worsened since last year,” he said.

Biden, the oldest person ever to serve as US president, has waved off questions about his age, but polls indicate voters have concerns about his ability to serve four more years if he wins in 2024.

Asked about the concerns over Biden’s age, White House press secretary Karine Jean-Pierre told reporters: “This is a president that works day in and day out, you know, in a grueling fashion with a grueling schedule, and delivers.”

About three-quarters of Americans – including more than half of Democrats and the vast majority of Republicans – say Biden is too old to work in government, according to a Reuters/Ipsos poll conducted on 6-13 February. Most Democratic respondents said the president remains mentally sharp but about half of them said he cannot handle the physical toll of the presidency.

Biden said during a PBS interview last week that any Americans concerned about his age should “watch me” perform the duties of the presidency.