Apheresis for Long Covid?

My most recent post was on microclots and their link to the long-term symptoms of Long Covid.

In the NHS we rely on various blood tests; prothrombin time, d-dimer and platelets amongst others to see if someone has a tendency for their blood to clot. As with most investigations related to Long Covid these are likely to be normal. However this does not exclude the existence of microclots.

A doctor with Long Covid is on his 6th cycle of Apheresis in Germany. He went there out of desperation - he was bed bound with fatigue and severe dysautonomia, on a very restricted diet due to MCAS, he was intolerant of light and sound, unable to sit up for more than 5 minutes and he had cognitive dysfunction.

6 cycles in he is able sit upright for periods, able to walk 500 metres and can now think clearly.

In between these treatments he is on 10000 units unfractionated heparin intravenously once a day. This "thins" the blood, breakdown clots and prevents further clots.

What is Apheresis?

It is a technique by which a particular substance or component is removed from the blood, the main volume being returned to the body. Like a blood "purification" or "cleanse" seen in kidney dialysis.

Where can I get it?

Currently I have only heard of centres in South Africa and India. For those in the UK the nearest centre is Germany. At the Apheresis Association -

What is the science?

Dr. Beate Roxane Jaeger pioneered in creating and publishing the first successful treatment for Long Covid in cooperation with the Apheresis Association. She had been successfully using a technique called Help - Apheresis - a procedure to remove fats in the blood of patients who are at high risk of atherosclerotic-related heart attacks due to excessive blood lipids. The technique has been very successful in this area reducing the occurrence of new heart attacks by almost 90 percent.

In both diseases atherosclerosis- related heart injury and Long Covid three factors play an important role: vascular inflammation, insufficient tissue perfusion and an increased tendency of the blood to clot.

The Apheresis Assosciation started the treatment in order to remove inflammatory substances and clotting substances in the blood of long haulers, especially in the microcirculation - the smallest arteries and veins.

These end branches of the blood vessels have the important task of supplying the tissue with energy and nutrients and transporting away the metabolic remnants. Her first patients were those who had had the acute Covid-19 infection at home but still had not recovered from it months later. All suffered from exertional dyspnoea (breathlessness) such as seen in heart failure, and other symptoms as well. These included a rapid pulse, angina pectoris and blood flow-related sensations such as cold hands and blue lips. Many patients also reported that they could hardly concentrate and would often lose the thread of their thoughts in the middle of a sentence. After one or more aphareses, the symptoms decreased noticeably in almost all patients. Ten of them are said to have been cured, another eight have taken a big step towards recovery, and only one person is said not to have benefited.

The therapy led to a rapid improvement in almost all symptoms, as varied as shortness of breath on exertion, loss of sense of smell, paralysis in the legs, memory lapses, cold hands, reduced oxygen saturation of the blood and exhaustion.

The inflammatory substances and clotting factors that enter the blood in increased quantities during infection make the blood much more viscous or thick. The improvement in blood flow is probably a major reason why so many patients feel so much better after apharesis.

How many of us noticed that we were very difficult to take blood from?

What is the cost?

The costs amount to about 1,300 euros per apheresis. They state that 2-3 treatments are needed.

There are limited free of charge treatments which can be applied for. The doctor currently having the treatment says:

"If there is one thing I will say it is this- there is an urgent need for treatment trials of anticoagulants. Too much time has been wasted getting excited about antibodies and cytokines which have dubious clinical significance. Whilst that research is important to find the cause of the clotting tendency, it can wait until we have started making people better".


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