Does “Blood Wash” Cure Long Covid?What we know about apheresis treatment and how much it costs

Britons who are dissatisfied with protracted symptoms such as fatigue, shortness of breath, and lack of proven treatment Long Covid Travel to private clinics in Cyprus, Germany and Switzerland is increasing to receive expensive “blood wash” treatments.

These can cost more than £ 13,000 per treatment, and some choose multiple trials. Anecdotal evidence suggests that some patients spend as much as £ 50,000 on multiple trials.

But what does the process need, is it safe and works?

what is that?

This treatment (technically known as apheresis) involves taking blood from the body and “filtering” it.

Basically, when the blood spins quickly in a “centrifugator” device, the blood separates into layers.

You can then filter out certain components or remove some layers and replace them with a more desirable liquid. The blood is then returned to the body through another vein.

Does it work?

in the case of Apheresis It has been proven in several commonly used conditions in the United Kingdom and abroad, such as sickle cell disease.

However, although this treatment is not specifically prohibited, it is not known to be available in the UK for long Covids.

Mark Toshner, an expert in translational respiratory medicine at the University of Cambridge, said blood washing is effective in some conditions, such as leukemia, where patients remove white blood cells and receive white blood cells collected from healthy donors. He said he could even do that.

As a long-term treatment for Covid, apheresis aims to work by filtering the parts of the blood that are involved in inflammation and coagulation.

“There is no evidence that blood lavage helps long Covids,” said Dr. Toshner. Me..

He states: There are no proven benefits and no trial version. It is unlikely that you will gain confidence in the coming months, or even next year or two.

“The way to prove or disprove it is to use a properly performed trial. There is a theory that it might work, but the evidence is not particularly strong.”

Shamil Haroon, a clinical instructor of primary care at the University of Birmingham and a researcher in the Long Covid Treatment (TLC) trial of unhospitalized patients, financially ruins patients by despair accessing treatment. I warned that it might be.

he I told the BMJ survey this month: “It’s not surprising that people who used to be highly functional, but are now debilitated, unable to work, and unable to be financially independent, seek treatment elsewhere. It is a completely rational response to such situations.

“But people can access these treatments and go bankrupt, and there is limited evidence of their effectiveness.”

He added that providing such treatment should only be done in the context of clinical trials.

Beverley Hunt, medical director of the charity Thrombosis UK, said:

“In this situation, treatment may or may not benefit them, but worryingly, there is also a risk of harm.”

Private clinics publish little or no data on the success of this treatment. This is because it is a time consuming process. At the same time, scientists argue that the long patient waiting list has little incentive to publish numbers that could indicate that it is not working and is reducing demand.

The lack of evidence in itself does not mean that the treatment is ineffective.

But the expert said Me They believe that it is “unlikely” to benefit, especially given that clinics are clearly reluctant to publish data.

Is it safe?

“As the procedure progresses, it is not a particularly high risk-it is a reasonably safe procedure that is very often used in clinical practice. [for other things].. But it’s not without risk. It’s important to remember that there are no risk-free interventions, “says Dr. Toshner.

He points out that the potential for serious problems is about the same as the risks associated with the AstraZeneca vaccine, and despite being a very small risk of 10,000 to 1 in 100,000, there is a lot of anxiety during deployment. Pointed out that caused.

So what are the risks?

Articles on TheConversation websiteDr. Toshner pointed out a World Health Organization treatise on “complications related to apheresis” that found evidence of hemolysis. [blood] During the apheresis procedure, cells can be damaged and hemoglobin can be released. The presence of hemoglobin in the circulation is recognized by pink or red plasma, linear blood, or a dark-looking filter. Donors may notice pink or red urine after collection. “

Air embolism, in which air bubbles are introduced into the patient’s circulation, has been found to be a more serious but very rare side effect.

“Air in the donor’s pulmonary circulation can occlude the pulmonary arteries of the lungs and cause cardiopulmonary symptoms. Air can flow into the arterial circulation through atrial septal defects and reduce blood flow to the brain. This very rare event can be recognized by bubbling sounds and sensations at the site of venous puncture with coughing, respiratory distress, anxiety, sweating, chest pain, confusion, tachycardia, hypotension, nausea, and vomiting. There is a transplant center, WHO’s cooperation center on alertness for human cells, tissues and organs.

Finally, apheresis is associated with the “citric acid response,” which is the hyperactivity of “neuromuscular” associated with lower levels of ionized calcium. Signs and symptoms include numbness and tingling in the lips and fingers, vibration, metallic taste, chills, tremors, light head, tension, muscle cramps, pulse speed and slowness, and shortness of breath. Symptoms can progress to carpopedal seizures and vomiting. If untreated, symptoms can progress to severe cardiac arrhythmias, including systemic muscle contractions (tetany) and cardiac arrest.

What other Long Covid treatments are available?

BMJ survey This month, many people with long covids say clopidogrel, apixaban, heparin, etc., based on the hypothesis that long covid symptoms are caused by small blood clots in the blood that block the flow of oxygen through the capillaries. I discovered that anticoagulants were also prescribed.

According to BMJ research editor Madlen Davies, “Some doctors and researchers believe that apheresis and anticoagulants are promising for long-term treatment, but desperate patients prove to be invasive. I’m worried about spending life-changing amounts on treatments that haven’t been done. “

But Dr. Toshner asks, “Who can blame long Covid patients for pursuing and unproven treatments?”

He added that whether patients choose to spend thousands of pounds on blood lavage treatment is an individual choice as long as they are aware of the risks and potential for success before proceeding.