Long Covid's Hidden Toll: Why US Patients Seek Treatment Overseas

NEW YORK, NY – July 29, 2026 – The shadow of the pandemic lengthens, and its true cost is only now coming into focus. A landmark study in the May 2026 JAMA Network Open reveals that Long Covid affects roughly one in six COVID-19 patients, a figure more than double previous government estimates. This translates to a staggering 18 million-plus Americans grappling with a debilitating post-viral illness, with the research showing new cases were still rising through mid-2024.

As the scale of this public health crisis becomes undeniable, a growing number of these patients are leaving the country. Desperate for relief and finding few options at home, they are traveling thousands of miles to clinics in Cyprus and Germany for a controversial blood-filtering treatment called H.E.L.P. Apheresis. Their exodus highlights a profound disconnect: a healthcare system that acknowledges a crisis but simultaneously denies coverage for the very treatments patients believe could be their lifeline.

The Coverage Gap: A System Failing its Patients

The primary driver of this medical tourism is a financial and logistical blockade within the United States. According to an analysis by the Apheresis Center in Cyprus—a key destination for these patients—American insurers routinely classify H.E.L.P. Apheresis as “experimental” for Long Covid. This classification is a near-certain death knell for coverage.

Major insurers like Aetna and UnitedHealthcare maintain policies that deem therapeutic apheresis unproven for conditions like Chronic Fatigue Syndrome (ME/CFS) and, by extension, Long Covid, which is not explicitly listed as a covered indication. The reason? The treatment lacks specific FDA approval for this use. While apheresis machines are common in US hospitals, they are almost exclusively used for established conditions like severe cholesterol disorders. The specialized clinical experience for post-viral illness is concentrated overseas.

This leaves patients facing an impossible choice. A full course of treatment in the US, if they can even find a clinic willing to perform it off-label, can cost between $15,000 and $30,000 out-of-pocket. In contrast, the Cyprus clinic offers sessions for approximately $2,050 each, with a typical course of five to six sessions costing around $12,000—a significant sum, but one that becomes the more accessible option when factoring in the sheer unavailability of the treatment stateside. “I drained my savings and started a GoFundMe,” one patient, who traveled to Cyprus after a year of debilitating fatigue and brain fog, shared online. “My disability claim was denied, I couldn’t work, and my doctors in the US had nothing left to offer. It felt like my only choice.”

This scenario is tragically common. Patient advocacy groups report a landscape littered with denied claims, not just for experimental treatments but also for basic care, all tangled in reviews of “medical necessity.” For many, the journey abroad isn’t a preference; it’s a last resort, born from a system that has left them behind.

A Lifeline or a Gamble? The Science of H.E.L.P. Apheresis

At the heart of this debate is the treatment itself: Heparin-Mediated Extracorporeal LDL/Fibrinogen Precipitation (H.E.L.P.) Apheresis. The procedure functions like a sophisticated form of dialysis. Blood is drawn from the patient, separated into plasma and cells, and the plasma is treated with heparin. This causes specific substances—including LDL cholesterol, inflammatory proteins, and the clotting protein fibrinogen—to clump together and filter out. The “cleansed” plasma is then recombined with blood cells and returned to the body.

The underlying theory is compelling. A growing body of research suggests Long Covid pathology is linked to persistent inflammation, endothelial damage, and the formation of tiny, durable “microclots” that impede blood flow and oxygen delivery. By physically removing fibrinogen and other inflammatory agents, H.E.L.P. Apheresis aims to break this cycle.

“The H.E.L.P. Apheresis machine has existed for almost 40 years,” notes Dr. Beate Jaeger, a medical advisor at the Apheresis Center. “We traditionally used them to treat high-risk patients with coronary heart disease... These machines remove excess damaging stuff from the blood, and they do it in a harmonised manner so it does no harm to the patients.”

Small-scale studies offer glimmers of hope. A 2023 pilot study in Molecular Psychiatry on 27 patients found that apheresis significantly reduced inflammatory markers and neurotransmitter autoantibodies, with microscopic analysis showing a visible reduction in the fibrous structures linked to microclots. However, the broader medical establishment remains cautious. A 2023 Cochrane Review found no rigorous evidence to support plasmapheresis for Long Covid outside of clinical trials, and a 2025 placebo-controlled trial found standard plasma exchange—a less specific procedure—ineffective. Experts rightly call for large-scale, randomized controlled trials to definitively prove efficacy and safety before the treatment can be considered a standard of care.

A Founder's Mission and the Patient Experience

For Markus Klotz, founder of the Apheresis Center, the mission is personal. He built the clinic after his own severe case of Long Covid was resolved through H.E.L.P. Apheresis five years ago. “There were two important factors for me from day one: accessibility, keeping these sophisticated treatments as accessible as possible, and achieving the best possible treatment results,” Klotz said. “Nobody should have to go through what I experienced whilst having severe and completely disabling chronic illness.”

The clinic has since treated over 1,200 patients, becoming a global hub for those with post-viral conditions. The outcomes, however, are a mixed bag, reflecting the complex and individual nature of Long Covid. Many patients report life-altering improvements in brain fog, fatigue, and pain. “After four sessions, I felt a clarity I hadn’t experienced in two years,” another patient wrote. “I could finally walk around the block without my heart rate monitor screaming at me.”

Yet, for others, the expensive gamble doesn't pay off. Some see only temporary benefits, while a few report no improvement at all, returning home with depleted bank accounts and unabated symptoms. In rare cases, patients have reported feeling worse after the procedure. This variability underscores the reality that H.E.L.P. Apheresis is not a panacea, but one potential tool for a condition whose mechanisms are still being unraveled.

A Public Health Reckoning

The phenomenon of Americans traveling abroad for H.E.L.P. Apheresis is more than a story about a single treatment; it’s a symptom of a larger systemic failure. The 18 million people affected by Long Covid represent a monumental challenge that the US healthcare infrastructure is struggling to meet. The NIH’s billion-dollar RECOVER initiative is diligently working to understand the disease and test potential therapies, but it has yet to yield an FDA-approved cure.

Into this void step clinics like the Apheresis Center, offering hope—at a high price—where domestic options are scarce. The demand they are seeing is a direct reflection of the desperation felt by millions. Until robust, accessible, and affordable treatments are available within the US, patients will continue to be forced into the roles of medical detectives, financial risk-takers, and global travelers. For the millions of Americans navigating this new reality, the search for relief is a testament to both human resilience and the profound gaps in a system under pressure.