Author: 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 simple words: As most people already know, the COVID-19 virus has a round shape covered with spikes, you can imagine the virus as if it’s a porcupine. In some cases, even though the patient is healed from the viral infection, a substantial amount of spikes that detached from the virus body stay in the patient’s bloodstream and system.

These spikes get caught and tangled in a protein called fibrinogen. You can understand by its name that fibrinogen has the shape of a fiber. Fibrinogen binds together blood platelets in case of an injury by creating a net of fibers tying the blood platelets and fixing them to a steady position where the injury has occurred.

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."

How can I know if I am carrying microclots in my bloodstream?

“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.” 

What are the symptoms patients experience?

“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. 

Can you please share with our readers your personal Long COVID experience?

“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, what makes Combination Therapy with H.E.L.P. Apheresis so effective in treating Long COVID patients?

“Regular Apheresis procedures are commonly used around the world to separate the different blood components. For example, during blood platelets donation, the donor is connected to an Apheresis machine that filters out the blood platelets while letting the rest of the blood components return to the bloodstream. It works like a strainer, the smaller the holes, the more components it can filter. Unfortunately viral spike proteins like COVID-19 has and microclots are tiny and pass through the common Apheresis machines filters.

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.”      

And Does H.E.L.P. Apheresis really help?

“We observe an 80% success rate right here at the clinic. Even among patients who for any reason can not take all the recommended H.E.L.P. Apheresis rounds we observed a significant improvement. Many patients report major recovery leaps when they get back home. It all depends on the severity of the condition.”

I must say that Markus speaks passionately about Long COVID and H.E.L.P. Apheresis but when I asked him the next question he actually glowed.

But H.E.L.P. Apheresis isn’t the only treatment you treat patients with in the clinic?

“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” 

I understand that you see prominent results, so why wasn’t the treatment yet approved by any health agency around the world?

“Long Covid clinical studies have only begun, if you for example look closely at the NHS UK website you’ll see they offer help only with symptoms management, not really a treatment or a cure. We expect the clinical trials and the approval procedures to last till at least 2030. What should Long COVID patients do until 2030? Lie in bed and wait?”

“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.”

You want to make the treatments more accessible, why Cyprus then?

“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.”

Finally Markus, is there anything you would like to say to other Long COVID and Post Vac or Chronic Illness patients out there?

Markus pauses for a few seconds to think and answers with an emotional expression

“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.”