Is blood washing an effective treatment for long COVID?

By Sarah Handzel, BSN, RN | Medically reviewed by Kristen Fuller, MD
Published September 6, 2022

Key Takeaways

  • The CDC estimates that 7.5% of American adults develop “long COVID” after their initial COVID-19 infection.

  • Growing numbers of people are traveling overseas for apheresis, a “blood washing” technique generally recommended for other conditions like leukemia or sickle cell anemia.

  • There is no proof that apheresis works to alleviate long COVID symptoms, and, coupled with other treatments like anticoagulation therapy, it may result in harm to patients.

Depending on the severity of symptoms, “long COVID” may have a profoundly negative impact on a patient’s quality of life.

Currently, there is no proven effective treatment—as a result, patients are turning to alternative treatments or therapies for other medical conditions.[]

One of these, apheresis, is gaining popularity overseas. But is it actually effective?

Symptoms of long COVID

According to the CDC, an estimated 7.5% of American adults experience long COVID symptoms after initial infection with COVID-19. Symptoms typically last 3 or more months and weren’t present before infection with the SARS-CoV-2 virus.[]

Long COVID sufferers report a wide variety of symptoms.

Beyond respiratory issues like cough, difficulty breathing, and shortness of breath, many patients experience other problems such as:[]

  • Change in smell or taste

  • Diarrhea, dizziness, fatigue, fever, rash

  • Difficulty concentrating or thinking clearly

  • Heart palpitations

  • Menstrual cycle changes

  • Muscle and joint pain

  • Sleeping problems

Blood washing to treat long COVID

Apheresis, or blood washing, was developed as a treatment for several serious illnesses.[]

Patients are connected to a special centrifuge machine, similar to how patients connect to dialysis machines. As blood is withdrawn, it’s separated into its four components—red blood cells, white blood cells, plasma, and platelets. Some of these components are directed into collection bags, while others are returned to the patient.

Apheresis benefits a large number of people living with serious, often debilitating diseases or conditions.

People with leukemia, sickle cell anemia, myasthenia gravis, and thrombotic thrombocytopenic purpura have all benefited from the procedure. The treatment may also be used to remove excess lipids and inflammatory proteins from the blood.[]

Now, relaxed travel restrictions and public demand for symptom relief have led many to seek apheresis treatment in foreign countries. Private clinics in Cyprus, Germany, and Switzerland offer apheresis, but it comes at a cost. The cost of the treatment itself, plus any travel and accommodation expenses, can quickly soar into the tens of thousands of dollars.

No proof of apheresis effectiveness for long COVID

Unfortunately for patients, there’s no evidence that apheresis alleviates long COVID symptoms.

“It’s unsurprising that people who were previously highly functioning, who are now debilitated, can’t work, and can’t financial support themselves, would seek treatments elsewhere,” said Shamil Haroon, researcher on the Therapies for long COVID in non-hospitalized patients clinical trial. “It’s a completely rational response to a situation like this. But people could potentially go bankrupt accessing these treatments, for which there is limited to no evidence of effectiveness.”

Concerned physicians cite the lack of clinical trial data as a reason to avoid apheresis for long COVID. It’s unknown whether the therapy actually benefits patients, and the risk of harm is very real.

In many cases, overseas apheresis clinics also advise patients to purchase several months’ worth of anticoagulant, antiviral, and over-the-counter drugs to supplement treatment and prevent reinfection with COVID-19. Some clinics also recommend that patients start a ketogenic diet.

However, it's unclear whether these recommendations actually do anything to benefit patients with long COVID. For some, they may actually cause more harm than good.

“I’m concerned this has been pushed onto a vulnerable group,” said Amitava Banerjee, MD, cardiologist and chief investigator on the Stimulate-ICP clinical trial for long COVID.

"We haven’t got solid evidence for single anticoagulation therapy—let alone triple."

Amitava Banerjee, MD

For some, taking these medications may have devastating consequences following an injury or fall. There is also typically no follow- up with patients on these prescription regimens.

A complex condition with no known root cause

A large part of the frustration felt by both patients and clinicians stems from the lack of understanding about the root causes of long COVID.

As research continues, some clinicians believe persistent immune system activation as a result of lingering SARS-CoV-2 virions contributes to the development of long COVID. Others point to the formation of microscopic blood clots following initial infection as a reason. Still more think infection with COVID-19 disrupts normal gut flora which, in turn, affects other organ systems.

These hypotheses form the basis of clinical research currently underway.

However, no research to date has focused on apheresis as a therapy for long COVID. It’s hoped that further research will provide better insight into the root causes of—and best treatments for—long COVID.

In the meantime, clinicians should direct patients with long COVID symptoms away from unproven treatments until research confirms their efficacy, instead working with them to help them manage these symptoms and hopefully find relief for them.

What this means for you

A growing number of people are traveling overseas for apheresis treatment for their long COVID symptoms. However, there is no solid evidence that this therapy is effective. Clinicians should be wary of recommending any unproven treatment for long COVID and should work with patients to develop better ways to manage symptoms.

Read Next: Targeting long-haul COVID: An exclusive interview on the latest research
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