Lack of treatment options for long Covid creates hype for unproven therapies

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PRI ESPL INT .CAMBRIDGE FES9 VIRUS-THERAPIES Long COVID: Without treatment options, it’s no wonder people are seeking unproven therapies like blood washing’ By Mark Toshner, Lecturer in Translational Respiratory Medicine, University from Cambridge Cambridge (UK), July 22 (The Conversation) A recent survey published by the British Medical Journal found that long COVID patients are traveling abroad to seek expensive blood-washing treatment. This experimental treatment, whose medical name is apheresis, consists of taking blood from the body and filtering it. Essentially, when blood is spun quickly in a centrifuge, it separates into layers. You can then filter out specific components or remove certain layers and replace them with more desirable fluids. The blood is then returned to the body through another vein. Apheresis can be effective for certain conditions such as sickle cell disease, where abnormal red blood cells can be removed, and leukemia, where the patient can have the white blood cells removed and even receive white blood cells taken from a healthy donor. As a treatment for long COVID, apheresis is proposed to filter circulating factors in the blood that are involved in inflammation and clotting. Its effectiveness has not yet been proven in a significant trial in this context and is not without risks. Nevertheless, it is attracting a lot of attention, especially through social media. But who can blame longtime COVID patients for pursuing experimental, unproven treatments? We have failed to fully define the spectrum of diseases contributing to the long COVID. More disappointingly, we have failed to start good quality trials of potential long-term COVID treatments. There is an empty space in the world where there should be a huge coordinated effort. A public health disaster is emerging As we understand the medium to long-term health issues that many people face after a COVID-19 infection, it’s like watching a car accident unfold in the slow motion. In the medium term, there is a modest but real increase in blood clots (these are not microclots but normal clots visible in traditional imaging). We notice this even in patients who have not been hospitalized with COVID-19. Meanwhile, new diagnoses of conditions like diabetes are more common among patients who have recovered from the virus. In the first year of the pandemic, more than one in four patients who survived in hospital had died or were back in hospital within the first few months of discharge. While vaccines probably helped, we still don’t know if that has changed in more recent waves. If these trends continue, healthcare services face a double whammy of patients needing care when first infected, and then the ongoing and significant healthcare needs of those patients. This is all before we have even taken up the challenge of dealing with the long COVID. We don’t have a clear idea of ​​how many people are affected, in part because of the lack of standardized definitions and diagnostic criteria. The impact cannot currently be underestimated. Today, patients are taking increasingly desperate measures in hopes of seeing an improvement in their chronic symptoms. Apheresis is not the first so-called panacea, and it will not be the last. We Need Trials Many of the leading proponents of unproven treatments like apheresis will tell you that we just need to start treating patients with long COVID; that there is no time to conduct clinical trials and that trials are not necessary anyway because anecdotal evidence is powerful. I heard this same argument about COVID-19 treatments, often done by the same people, at the start of the first wave. This turned out to be the wrong approach. Treatments shown as promising at first, such as hydroxychloroquine and ivermectin, later proved ineffective. Therapies like dexamethasone and tocilizumab, meanwhile, have been shown to save lives in rigorous trials and have changed the course of the pandemic. In both vaccines and antiviral treatments, we have proven that we can run trials at scale and at the pace of the pandemic. But at this time, we are not applying these lessons to long COVIDs. My colleagues and I set up the HEAL-COVID study, which recruited over 1,000 people hospitalized with COVID-19. We aim to identify possible treatments that could improve longer-term outcomes for these patients and, ideally, prevent the onset of chronic health conditions. However, when we go further down the road and look at the long established COVID, research in terms of treatment is currently scarce. There are exceptions such as the STIMULATE-ICP community treatment study, but they are unique in that they stand out from a less crowded field. In this lack of evidence, a combination of misguided evangelists, well-meaning people who are simply trying to offer hope and help, and the worst kind of charlatans who prey on the sick and vulnerable. We must therefore urgently put on the agenda the requirement for well-funded, large-scale and definitive clinical trials. If we can do this at the height of a pandemic with a few weeks notice, why is it any different now? Trials for long COVID treatments are indeed complex due to, among other factors, the wide range of symptoms and ideas about what might be driving them. But this complexity is not insurmountable. If we do not invest resources and funding to carry out these trials, many people will be exposed to unproven treatments at great expense and with potential risks. And in the end, we still won’t know if any of them actually work. The burden on health systems, not to mention individuals and families, will be enormous. (The conversation) NSA 07221424 NNNN

(Only the title and image of this report may have been edited by Business Standard staff; the rest of the content is auto-generated from a syndicated feed.)

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