Chronic post-COVID-19 syndrome and chronic fatigue syndrome: Is there a role for extracorporeal apheresis?

Abstract

As millions of patients have been infected by SARS-CoV-2 virus a vast number of individuals complain about continuing breathlessness and fatigue even months  after the onset of the disease. This overwhelming phenomenon has not been well  defined and has been called "post-COVID syndrome" or "long-COVID" [1]. There are  striking similarities to myalgic encephalomyelitis also called chronic fatigue  syndrome linked to a viral and autoimmune pathogenesis. In both disorders  neurotransmitter receptor antibodies against ß-adrenergic and muscarinic  receptors may play a key role. We found similar elevation of these autoantibodies  in both patient groups. Extracorporeal apheresis using a special filter seems to  be effective in reducing these antibodies in a significant way clearly improving  the debilitating symptoms of patients with chronic fatigue syndrome. Therefore,  such a form of neuropheresis may provide a promising therapeutic option for  patients with post-COVID-19 syndrome. This method will also be effective when  other hitherto unknown antibodies and inflammatory mediators are involved.