“Blood washing” or apherisis is a therapy that many people with Persistent Covid or Long Covid They see it as an option to end or, at least palliate, their disabling symptoms that prevent them from leading a life similar to the one they had before they were infected with the coronavirus.
However, until now there are no clinical trials that have demonstrated the efficacy of this technique for persistent Covid and, as Isabelle Delgado points out, Long Acting Covidwould not be indicated for all patients.
According to an investigation by “BMJ” and ITV News, many people travel to private clinics in Cyprus, Germany and Switzerland to undergo apheresis, a blood-filtering treatment normally used for patients with lipid disorders that have not responded to drugs, and anticoagulant therapy.
But,rAre these techniques really effective for persistent Covid? Is there enough evidence about its effectiveness?
The World Health Organization (WHO) estimates that between 10% and 20% of patients suffer from symptoms for at least two months after an acute Covid-19 infection, a phenomenon commonly known as persistent Covid.
However, at present, there is no internationally agreed treatment pathway for this disease.
Apheresis is a technique that involves inserting needles into each arm and passing the blood through a filter, separating the red blood cells from the plasma. Plasma is filtered before recombining with red blood cells and returned to the body through another vein.
Apheresis is a blood-filtering treatment typically used for patients with lipid disorders.
The research now appearing in the BMJ includes details of people who have tried the treatment, such as Gitte Boumeester, a psychiatrist from Almelo, the Netherlands, who, after contracting the virus, developed severe symptoms. Gitte was forced to leave her job in November 2021, after two failed attempts to return to work.
Boumeester learned about the apheresis treatment through a Long Covid Facebook group.
After visiting the Long Covid Center in Cyprus to receive the treatment, at a cost of more than 50,000 euros, and returned home without improving his symptoms. She received six rounds of apheresis, as well as nine sessions of hyperbaric oxygen therapy and an intravenous vitamin drip at a private clinic next door to the center, Poseidonia.
In addition, Boumeester was required to sign a consent form at the Long Covid Center prior to undergoing apheresis, which was deemed inappropriate by lawyers and doctors.
He was also advised to buy hydroxychloroquine as an early treatment package in case he was re-infected with Covid-19, despite international scientific consensus that the drug is “unlikely” to have any benefit in its prevention.
“We, as a clinic, do not advertise or promote. We accept patients who have microcirculation problems and want to be treated with apheresis. If a patient needs a prescription, they are evaluated individually by our doctor or the patient is referred to other specialized doctors when necessary, “he told BMJ Marcus Klotzco-founder of the Long Covid Center.
A spokesperson for the Poseidonia Clinic said that all treatments offered “are always based on the medical and clinical evaluation of our doctors and clinical nutritionists, diagnosis through blood tests with laboratory follow-up according to good medical practice.”
Many researchers worry that patients are spending sums on invasive and unproven therapies
Isabelle Delgado
Long Acting Covid
While some doctors and researchers believe apheresis and blood-thinning drugs may be promising treatments for persistent Covid, others worry that desperate patients are spending life-changing sums on unproven and invasive treatments.
Because, as Shamil Haroon, professor at the University of Birmingham and investigator of the Therapies for Long Covid in Non-hospitalized patients (TLC) trial, points out, this “experimental” treatment should only be carried out in the context of a clinical trial.
“It’s no wonder that people who were once fully functional and are now so debilitated and powerless, unable to work and unable to support themselves financially, seek treatment elsewhere,” he says.
“It’s a completely rational response to a situation like this. But people could go bankrupt by accessing these treatments, which have limited or no efficacy.”
Delgado knows that there are some Spanish patients who have undergone this therapy, although «It’s not Benito’s purge“, recognize. “I know people who have done it; but to cure, they have not been completely cured».
In Spain there are no centers that are applying this technique, says Delgado, although the Germans Trias i Pujol University Hospital is assessing its use in selected patients.
I know people who have done it; but heal, they have not healed at all
In February last year, Beate Jaeger, an internal medicine doctor, began treating longtime Covid patients with apheresis at her clinic in Mulheim, Germany, after reading reports that Covid causes blood clotting problems. blood. As she told the BMJ, she has already treated thousands of people at her clinic, with success stories spreading through social media and word of mouth.
Jaeger accepts that it is an experimental treatment, but maintains that the trials take too long and the pandemic has left patients desperately ill.
The North Rhine Medical Association, which examines whether doctors have violated its professional code of conduct, told the BMJ that it has not received any complaints about Jaeger or his clinic from patients or other organisations, but will investigate if it does.
The research also found that apheresis and associated travel costs are so expensive that patients are setting up fundraising pages on websites like GoFundMe to raise the money.
Chris Witham, a 45-year-old businessman and long-time Covid-19 sufferer who spent around £7,000 on apheresis treatment (including travel and accommodation costs) in Kempten, Germany, last year, says : “I would have sold my house and given it away to improve it, without thinking twice.”
Existing research has suggested that “microclots» present in the plasma of people with Covid could be responsible for their symptoms.
But experts consulted by the BMJ and ITV News have said more research is needed to understand how microclots form and whether they are the cause of symptoms.
Others are also concerned about the lack of follow-up of patients when they leave clinics after they have been prescribed blood-thinning medications.
Disease biomarker
“Maybe [los microcoágulos] may be a biomarker of disease, but how do we know they are causal?” asks Robert Ariens, Professor of Vascular Biology at the University of Leeds Medical School.
Ariens believes that clinics offering apheresis and anticoagulant therapy are prematurely providing treatment based on a hypothesis that needs further scientific investigation.
“If we do not know the mechanisms by which microclots are formed and whether or not they cause the disease, it seems premature to design a treatment to eliminate microclots, since both apheresis and triple anticoagulation are not without risks, the the more obvious the hemorrhage, ”he adds.