Post COVID and Apheresis: 2022 Review Summary
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Study Overview
This 2022 review article discusses the emerging clinical experience with extracorporeal apheresis in patients experiencing persistent symptoms following COVID-19 infection (commonly referred to as Post COVID or Long COVID).
The authors summarise proposed biological mechanisms underlying Post COVID symptoms and describe observational experiences from centres in Germany where apheresis has been used.
Importantly, the authors state that randomised controlled trials have not yet been completed to confirm efficacy.
Background – Post COVID Mechanisms Discussed
The authors considered several biological factors:
• Chronic systemic inflammation
• Lipid transport and cholesterol metabolism
• Oxidative stress
• Blood–brain barrier integrity
• Vascular and metabolic signalling
The review proposed that removing selected plasma components through extracorporeal filtration could potentially influence these pathways. However, the article emphasised the need for structured clinical trials to evaluate safety, outcomes, and efficacy in defined patient populations.
Rationale for Apheresis
Apheresis is described as an extracorporeal procedure designed to remove selected plasma components, including:
- Lipids
- Inflammatory mediators
- Autoantibodies
- Certain high molecular weight proteins
The review explains that different apheresis techniques exist, including filtration-based methods, immunoadsorption, and precipitation approaches.
The article discusses theoretical rationale for autoantibody removal in Post COVID, particularly where autoimmune mechanisms are suspected.
Clinical Experience Reported
The review references observational experience from German centres treating patients with:
- Post COVID
- Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
The authors report short-term improvements in some patients. However:
No placebo-controlled trials were included
No randomised controlled trials were available
Treatment protocols varied between centres
Patient groups were heterogeneous
Key Conclusion of the Study
The authors state:
There is currently no high-quality randomised controlled trial data confirming efficacy
A sham-controlled, multi-arm trial is needed
Defined patient groups and standardised outcome measures are essential
The paper emphasises that while observational results are described as promising, robust scientific validation remains necessary.
Clinical Context
This publication represents a review of emerging clinical experience rather than definitive evidence of effectiveness.
Treatment decisions should always be made in consultation with a qualified healthcare professional, and patients should be informed that controlled clinical trial data is still limited.
Study Citation
Steenblock C, Walther R, Tselmin S, et al.
Post COVID and Apheresis – Where are we Standing?
Hormone and Metabolic Research. 2022;54:715–720.
DOI: 10.1055/a-1945-9694