Apheresis, a blood-filtering procedure typically used for patients with lipid diseases who have not responded to medication, and anti-clotting therapy are two treatments that patients are traveling to private clinics in Cyprus, Germany, and Switzerland for.

A new report published today found that thousands of people with long covid symptoms go overseas to seek expensive but unproven treatments such as “blood washing.”

Apheresis, a blood-filtering procedure typically used for patients with lipid diseases who have not responded to medication, and anti-clotting therapy are two treatments that patients are traveling to private clinics in Cyprus, Germany, and Switzerland for.

However, experts worry whether these invasive procedures should be made available without enough proof.

Marcus Klotz, the clinic’s co-founder, and a few of the patients were interviewed by ITV News while they were in Cyprus. 

According to estimates from the World Health Organization (WHO), between 10 and 20 percent of patients experience symptoms for at least two months following an acute covid-19 infection. This condition is referred to as long covid.

According to the most recent official data, approximately 23 million people in the US self-reported long-term covid symptoms, which might include fatigue, muscle weakness, breathing and sleep issues, memory problems, worry or despair, chest pains, and loss of smell or taste.

There is currently no universally recognized treatment protocol for the illness.

Apheresis includes inserting needles into each arm and passing the blood through a filter to separate the red blood cells from the plasma. A separate vein is used to return the plasma to the body after being filtered and mixed with red blood cells.

The investigation includes information on those who have tried the treatment, including Gitte Boumeester, a trainee psychiatrist in Almelo, Netherlands, who experienced severe long-lasting symptoms after contracting the virus. After two failed attempts to return to work, she was forced to resign from her position in November 2021.

Boumeester discovered apheresis, or “blood-washing,” through a Facebook community for long-covid patients.

She traveled to The Long Covid Center in Cyprus for the procedure, which cost more than $50,000, but her symptoms did not get any better when she got back home. She had six cycles of apheresis, nine cycles of hyperbaric oxygen therapy, and an intravenous vitamin drip at the private Poseidonia clinic next to the Center.

Before undergoing apheresis, Boumeester was requested to sign an inadequate permission form at the Long Covid Center, according to lawyers and clinicians.

Despite a Cochrane review released in March 2021 indicating that it is “unlikely” the drug has a benefit in the prevention of covid-19, she was also advised to purchase hydroxychloroquine as an early treatment package in case she was reinfected with covid-19.

The Long Covid Center co-founder Marcus Klotz told The BMJ:  “We as a clinic do neither advertise, nor promote. We accept patients that have microcirculation issues and want to be treated with HELP apheresis… If a patient needs a prescription, it is individually assessed by our doctor or the patient is referred to other specialized doctors where needed.”

All therapies are “always based on medical and clinical evaluation by our doctors and clinical nutritionist, diagnosis via blood tests with lab follow ups as per good medical practice,” according to a Poseidonia clinic representative.

While some physicians and researchers think apheresis and anticoagulant medicines to be viable treatments for chronic covid, others are concerned that desperate patients are spending life-altering sums on invasive, unproven treatments.

Such “experimental” treatment, in the opinion of Shamil Haroon, clinical lecturer in primary care at the University of Birmingham and researcher on the Therapies for Long Term in Non-Hospitalized Patients (TLC) trial, should only be carried out as part of a clinical trial.

“It’s unsurprising that people who were previously highly functioning, who are now debilitated, can’t work, can’t financially support themselves, would seek treatments elsewhere,” he points out.

It’s an entirely reasonable answer in this circumstance. But since there is little to no proof of the efficacy of these treatments, people can end up bankrupt trying to get them.

After reading reports that covid affects blood coagulation, internal medicine specialist Dr. Beate Jaeger started using apheresis to treat long-covid patients at her Mulheim, Germany, clinic in February of last year. The BMJ said that she has already treated thousands of patients in her clinic, with success tales circulating online and through word-of-mouth.

Jaeger acknowledges that the medicine is still in its early stages of development, but claims that this is a problem given how sickly patients are as a result of the pandemic.

The North Rhine Medical Association, which investigates whether doctors have breached their professional code of conduct, told The BMJ that it had not received any complaints about Jaeger or her clinic from patients or other organizations, but that it would look into it if it did.

Additionally, it was discovered that because apheresis and related travel expenses are so pricey, patients are creating fundraising pages on sites like GoFundMe to raise the funds.

Chris Witham, a 45-year-old businessman from Bournemouth who has had long-term covid and spent about $ 8500 last year on apheresis therapy in Kempten, Germany (including travel and lodging expenses), says: “I’d have sold my house and given it away to be better, without a second thought.”

Existing research suggests that “microclots” in the plasma of persons with long covid may be the cause of long covid symptoms. But according to specialists consulted by The BMJ and ITV News, additional study is necessary to determine how microclots arise and whether they are responsible for persistent symptoms.

Others are concerned about the lack of follow-up treatment provided to patients after they leave clinics with anticoagulant medication prescriptions.

The University of Leeds School of Medicine’s Robert Ariens, a professor of vascular biology, adds: “They [microclots] may be a biomarker for disease, but how do we know they are causal?”

He thinks the clinics delivering apheresis and anticoagulant therapy are starting treatment too soon based on a theory that requires further scientific investigation.

“If we don’t know the mechanisms by which the microclots form and whether or not they are causative of disease, it seems premature to design a treatment to take the microclots away, as both apheresis and triple anticoagulation are not without risks, the obvious one being bleeding,” he continues.

Image Credit: Getty

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