Autore: S. Margalit
While the COVID-19 pandemic’s grip has loosened, millions worldwide grapple with long-term effects. A recent JAMA Network report estimates 7% of US adults, or nearly 18 million, experience Long COVID. Scientists pinpoint microscopic blood clots as a potential culprit. I spoke with Markus Klotz, co-founder of the Apheresis Center in Larnaca, Cyprus, and a former Long COVID patient himself, to delve deeper into the condition and their promising treatment protocol.
Markus, many Long COVID patients struggle despite seeming recovery. What’s the cause?
"In parole povere: Come la maggior parte delle persone già sa, il virus COVID-19 ha una forma rotonda ricoperta di punte, si può immaginare il virus come se fosse un porcospino. In alcuni casi, anche se il paziente è guarito dall'infezione virale, una quantità sostanziale di spuntoni staccatisi dal corpo del virus rimane nel flusso sanguigno e nel sistema del paziente.
Queste punte si impigliano e si aggrovigliano in una proteina chiamata fibrinogeno. Dal nome si capisce che il fibrinogeno ha la forma di una fibra. Il fibrinogeno lega le piastrine del sangue in caso di lesione, creando una rete di fibre che lega le piastrine del sangue e le fissa in una posizione stabile dove si è verificata la lesione.
Once a COVID-19 spike gets caught in a fibrinogen net, it weakens its strength and flexibility. The fibrinogen net gets broken and pieces of it start circulating the blood stream creating fibrin aggregates, so called microclots that researchers have found to cause quite a substantial amount of symptoms. Especially as they include amyloid proteins which makes them extremely hard to dissolve. Of course in many cases there are other processes involved – often downstream of the microclots/hypercoagulation – hyperinflammation, autoimmune processes and neurological issues.”
Come posso sapere se sono portatore di microclots nel sangue?
“I recommend you first consult your doctor. There is a few research laboratories that test for microclots and endothelial damage. You can also take the online diagnostic screening questionnaire test available on our website, developed by our medical advisor Dr. Gustavo Aguirre-Chang. By now though we have more accurate molecular diagnostic tests – spike protein persistence tests that show where spike remains in the patients’ system – in the serum, the exosomes or the immune cells.”
Quali sono i sintomi che i pazienti avvertono?
“The National Healthcare Service in the UK (NHS UK) has published a few symptoms like extreme tiredness (fatigue), shortness of breath, problems with your memory and concentration (“brain fog”), heart palpitations, dizziness and joint pain and muscle aches. For so many patients we meet here in our clinic, the symptoms are so severe that they are bedridden close to 23 hours a day, but there is also many that have more mild versions but are still struggling a lot to live a normal life.”
When Markus fell ill at the end of 2020 after contracting Covid and his life was taken away from him through a severe case of Long Covid, he, his family and friends already had lost hope of a recovery when a therapy in Mülheim, Germany brought him back to life again. Dr. Beate Jaeger treated him with H.E.L.P. Apheresis for Long Covid. He was patient Nr. 14 in her published case study.
Può condividere con i nostri lettori la sua personale esperienza di Long COVID?
“I was bedridden, constantly fatigued, with terrible muscle aches. The slightest exertion left me breathless, and my mind felt perpetually foggy. I couldn’t even watch TV or read the news. Depression and anxiety weighed heavily. No doctor could diagnose or offer any treatment. Joining Dr. Jaeger’s H.E.L.P. Apheresis study became my lifeline “
After his recovery, Markus took upon himself a mission to make the treatment available for more patients and together with his best friends Constantinos Georgiou and Silke Fischer with the support of Dr. Beate Jaeger opened the Apheresis Center in Larnaca with Dr. Irina Pavlik Marangos, who leads the medical team as the Medical Director. Utilizing their clinical experience and cooperating with doctors and researchers from all over the world, they developed ‘The Cyprus Protocol’, a combination therapy to treat Long COVID and other chronic conditions”
Markus, cosa rende la terapia combinata con H.E.L.P. aferesi così efficace nel trattamento dei pazienti con COVID lunga?
"Le procedure di aferesi sono comunemente utilizzate in tutto il mondo per separare i diversi componenti del sangue. Per esempio, durante la donazione di piastrine, il donatore viene collegato a una macchina per aferesi che filtra le piastrine e lascia che il resto dei componenti del sangue ritorni nel flusso sanguigno. Funziona come un colino: più piccoli sono i fori, più componenti può filtrare. Sfortunatamente, le proteine virali come COVID-19 e microclots sono minuscole e passano attraverso i filtri delle macchine per aferesi.
However, H.E.L.P. Apheresis works differently. Instead of using mechanical components to filter the blood, H.E.L.P. Apheresis cleans the blood using several chemical solutions and processes, literally making the machine a “live laboratory”. First it separates the plasma from the rest of the blood. Then injecting an acetate buffer it turns the plasma’s acidity level to 5,2 pH, creating an environment in which spike proteins, pathogenic proteins and microclots and other toxins and pathogens irreversibly bind to the now injected heparan sulfate, a form of heparin. This process is called precipitation – the solidified ‘precipitate’ remains in a filter-like structure (precipitation filter) with a surface size of over two football fields. The clean plasma is then going through a counter-dialysis with bicarbonate to normalise the pH value again and after that through ultrafiltration/a heparin adsorber and is finally warmed up to body temperature and returned to the bloodstream together the rest of the blood components.
Most forms of Apheresis procedures are very different and therefore less efficient – a selective absorber or precipitation seems to be key.”
E H.E.L.P. L'aferesi è davvero utile?
"Osserviamo una percentuale di successo dell'80% proprio qui in clinica. Anche tra i pazienti che per qualsiasi motivo non possono assumere tutti i cicli di aferesi raccomandati da H.E.L.P. abbiamo osservato un miglioramento significativo. Molti pazienti riferiscono di aver recuperato molto bene una volta tornati a casa. Tutto dipende dalla gravità della condizione".
Devo dire che Markus parla con passione di Long COVID e H.E.L.P. Apheresis, ma quando gli ho posto la domanda successiva si è davvero illuminato.
Ma H.E.L.P. L'aferesi non è l'unico trattamento con cui trattate i pazienti in clinica?
“H.E.L.P. is the crown jewel of the treatment as it is the core part of ‘The Cyprus Protocol’ we use in the clinic. It’s a combination of several different therapies designed to clean the blood from microclots, support the recovery process and provide the patient with means to prevent the next infection.
It includes clinical nutrition supervision, IV therapy, antiviral medications, IVIG IgM enhanced therapy, hyperthermia, hyperbaric oxygen therapy, immunoadsorption therapy and post treatment support by a health coach. Each treatment plan is tailored by Dr. Irina Pavlik Marangos and our clinical nutritionist and clinical director Chryso Zorbas. While not every patient will be undergoing all the treatments, specific combinations of some of them are ‘doing wonders’ for Long COVID and Post Vac, as well as for chronic illness patients”
Mi sembra di capire che lei vede risultati importanti, quindi perché il trattamento non è stato ancora approvato da nessuna agenzia sanitaria in tutto il mondo?
"Gli studi clinici sul Long Covid sono solo iniziati, se per esempio si guarda attentamente al sito web dell'NHS UK si vedrà che offre un aiuto solo per la gestione dei sintomi, non un vero e proprio trattamento o una cura. Ci aspettiamo che gli studi clinici e le procedure di approvazione durino almeno fino al 2030". Cosa dovrebbero fare i pazienti di Long COVID fino al 2030? Stare a letto e aspettare?".
“Every treatment we offer our patients is clinically approved by health agencies around the world and considered as safe, they are just not labelled as ‘Long Covid or Post Vac treatments’ yet.”
Volete rendere i trattamenti più accessibili, perché Cipro allora?
“Well, the answer lies in your question. The operating costs for a clinic like ours are higher in the rest of the European Union or in the USA for example, thus letting us provide the treatments at a better cost. 70 direct flights and English language are just two more of the long list of reasons we chose Cyprus. The island itself has a high standard private health infrastructure. I have to say that the beautiful view of the Mediterranean and the sunny blue sky also help our patients recovery. I like what Stephen, one of our patients said: ‘We managed to blend German efficiency and Cypriot hospitality at our clinic.”
Infine, Markus, c'è qualcosa che vorresti dire ad altri pazienti con COVID lunga, post Vac o malattia cronica là fuori?
Markus si ferma qualche secondo a riflettere e risponde con un'espressione emozionata
“For me the worst part was the mental part, not knowing what you really have is devastating, but my message as a former patient to other patients is don’t lose hope! Speak to your doctor, ask for available treatments and don’t lose hope. We also provide free consultation to patients from all over the world and you are welcome to do that too.”
