COVID-19 and Therapeutic Apheresis

Abstract

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, is an unprecedented challenge for the global community. The pathogenesis of COVID-19, its complications and long term sequelae (so called Long/Post-COVID) include, in addition to the direct virus-induced tissues injury, multiple secondary processes, such as autoimmune response, impairment of microcirculation, and hyperinflammation. Similar pathological processes, but in the settings of neurological, cardiovascular, rheumatological, nephrological, and dermatological diseases can be successfully treated by powerful methods of Therapeutic Apheresis (TA). We describe here the rationale and the initial attempts of TA treatment in severe cases of acute COVID-19. We next review the evidence for the role of autoimmunity, microcirculatory changes and inflammation in pathogenesis of Long/Post COVID and the rationale for targeting those pathogenic processes by different methods of TA. Finally, we discuss the impact of COVID-19 pandemic on patients, who undergo regular TA treatments due to their underlying chronic conditions, with the specific focus on the patients with inherited lipid diseases being treated at the Dresden University Apheresis Center.

A practical approach for the treatment of post-COVID symptoms

“…Beyond pharmacological therapy, H.E.L.P. apheresis is gaining increasing importance [ 10 ]. Based on its successful use on patients with hyperlipidemia, arteriosclerosis, coronary heart disease, neurological and rheumatological diseases as well as in cases of acute bacterial and viral infections, its use in long COVID or post-COVID seems promising [ 10 ].…”

“…apheresis is gaining increasing importance [ 10 ]. Based on its successful use on patients with hyperlipidemia, arteriosclerosis, coronary heart disease, neurological and rheumatological diseases as well as in cases of acute bacterial and viral infections, its use in long COVID or post-COVID seems promising [ 10 ]. Apheresis is a medical treatment that was initially developed for the removal of lipids in severe dyslipidemias [ 11 ].…”

The Role of Endocrine and Metabolic System in COVID-19 Disease – The Transcampus Experience and Review of Evidence From International Collaborating Groups

“…Specifically, the symptoms and clinical signs of Long-COVID, the association of metabolic and endocrine diseases with the risk of developing Long-COVID and the effects of Long-COVID on aggravation of metabolic and endocrine diseases are presented [10]. Finally, nutritional approaches (e. g., intermittent fasting enriched with selected nutritional cofactors) [11], as well as therapeutic apheresis procedures are discussed as potential treatments for Long-COVID [12].…”