作者：S：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?
"简单地说：大多数人都知道，COVID-19 病毒呈圆形，浑身长满尖刺，你可以把它想象成豪猪。在某些情况下，即使患者的病毒感染已经痊愈，但从病毒体内脱落的大量尖刺仍会留在患者的血液和体内。
这些尖刺会被一种叫做纤维蛋白原的蛋白质抓住并缠结在一起。从纤维蛋白原的名字就可以看出，它的形状就像一根纤维。受伤时，纤维蛋白原会将血小板结合在一起，形成一个纤维网，将血小板捆绑起来，固定在受伤的地方。
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.”
如何知道我的血液中是否含有microclots ？
“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.”
患者会出现哪些症状？
“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.
您能与我们的读者分享一下您个人的 Long COVID 体验吗？
“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”
马库斯，是什么让H.E.L.P. Apheresis 联合疗法对治疗长 COVID 患者如此有效？
"世界各地普遍采用常规的血液分离程序来分离不同的血液成分。例如，在捐献血小板时，捐献者会被连接到一台血液分离机上，这台机器会过滤出血小板，而让血液中的其他成分回到血液中。它的工作原理就像一个过滤器，孔越小，能过滤的成分就越多。不幸的是，像 COVID-19 和microclots 这样的病毒尖峰蛋白非常微小，可以通过普通的血液透析机过滤器。
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.”
H.E.L.P. Apheresis 真的有用吗？
"我们诊所的成功率高达 80%。即使是那些因各种原因无法按时完成H.E.L.P. Apheresis 治疗的患者，我们也观察到他们的病情有了显著改善。许多患者在回家后都报告说病情有了很大的恢复。这完全取决于病情的严重程度"。
我必须说，马库斯对 Long COVID 和H.E.L.P. Apheresis 充满热情，但当我向他提出下一个问题时，他居然容光焕发。
但H.E.L.P. 血液透析并不是您在临床上治疗病人的唯一疗法？
“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”
我知道你们看到了显著的效果，那么为什么这种疗法还没有得到世界上任何卫生机构的批准呢？
"Long Covid 的临床研究才刚刚开始，举例来说，如果你仔细查看英国国家医疗服务系统的网站，就会发现它们提供的帮助只是症状控制，而不是真正的治疗或治愈。我们预计临床试验和审批程序至少要持续到 2030 年。在 2030 年之前，长 COVID 患者该怎么办？躺在床上等待吗？
“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.”
你想让更多人接受治疗，为什么是塞浦路斯？
“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.”
最后，马库斯，你有什么话想对其他长期 COVID 和 Vac 后或慢性病患者说吗？
马库斯停顿了几秒钟，想了想，表情激动地回答道
“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.”
