Our three-phase treatment approach targets the root mechanisms of Long COVID — microclots, impaired microcirculation, immune dysregulation, and mitochondrial dysfunction — through precision diagnostics and individualized biological therapies.
Effective treatment of Post-COVID syndrome requires addressing the underlying pathology, not simply managing symptoms. At St. George Hospital, our treatment protocol is designed by Dr. Julian Douwes and informed by the clinical research of Dr. Beate Jaeger into microclots and microcirculation.
The core insight guiding our approach: if fibrinoid microclots are obstructing capillary blood flow, if the vascular endothelium is damaged, and if immune dysregulation is sustaining chronic inflammation, then treatment must target these mechanisms directly. Symptom management alone — while important for quality of life — does not address the biological drivers of the condition.
Our protocol therefore combines microclot removal (via therapeutic apheresis), oxygen delivery enhancement (via HBOT), mitochondrial repair (via IHHT), immune modulation, and carefully paced physical rehabilitation into a structured, individualized treatment program.
Sublingual capillaroscopy and functional microcirculation testing to measure capillary density, flow velocity, and perfusion quality in real time.
Fluorescence microscopy of blood samples to identify fibrinoid microclot burden, informing decisions about apheresis frequency and duration.
Assessment of ATP production capacity, oxidative stress markers, and metabolic parameters to quantify cellular energy impairment.
Based on diagnostic findings, Dr. Julian Douwes designs an individualized treatment protocol combining the following biological therapies. Treatment typically takes place over a 2-3 week intensive inpatient program.
The cornerstone of our microclot-targeted therapy. Heparin-induced Extracorporeal LDL Precipitation selectively removes fibrinoid microclots, fibrinogen, inflammatory lipoproteins, and autoantibodies from the blood. Multiple sessions are typically required, with microcirculation improvement measurable after each treatment.
Breathing pure oxygen under increased atmospheric pressure forces oxygen into tissues that impaired microcirculation cannot adequately supply. HBOT supports neurological recovery, promotes angiogenesis (new blood vessel formation), reduces inflammation, and enhances endothelial repair.
Alternating controlled periods of low-oxygen and high-oxygen breathing triggers mitochondrial biogenesis -- the creation of new, healthy mitochondria. This directly addresses the cellular energy deficit that drives Post-COVID fatigue and exercise intolerance.
High-dose intravenous vitamin C, glutathione, phosphatidylcholine, and targeted immune-modulating compounds address chronic immune activation, reduce oxidative stress, support endothelial repair, and restore immune balance in patients with persistent inflammatory dysregulation.
Major autohemotherapy with ozone improves blood rheology (flow characteristics), enhances tissue oxygen utilization, exerts broad antimicrobial effects, and stimulates antioxidant defense systems. Particularly beneficial for patients with concurrent infections or severe oxidative stress.
Carefully paced rehabilitation, respiratory training, autonomic reconditioning, and gentle movement therapy are integrated throughout the treatment program. Intensity is calibrated to avoid post-exertional malaise while progressively rebuilding functional capacity.
Depending on individual diagnostic findings, the following additional therapies may be integrated into the treatment plan:
The treatment program does not end when the inpatient stay concludes. Phase 3 focuses on sustaining the improvements achieved and building long-term resilience against relapse.
Most patients undergo a 2-3 week initial treatment program. Some patients benefit from a second treatment cycle 3-6 months later, particularly those with high initial microclot burden or severe immune dysregulation.
“The removal of microclots through therapeutic apheresis, combined with measures to improve microcirculation and address endothelial dysfunction, represents one of the most promising avenues for treating Post-COVID syndrome at its root cause rather than at the symptom level.”
Dr. Beate Jaeger, M.D. — Clinical research into fibrinoid microclots and microcirculation in Post-COVID syndrome
Dr. Jaeger’s clinical observations at Klinik St. Georg have demonstrated measurable improvement in microcirculation parameters following targeted treatment, with corresponding improvements in patient-reported symptom scores across fatigue, cognitive function, and exercise tolerance domains. These findings continue to inform and refine the treatment protocols designed by Dr. Julian Douwes for the Post-COVID program at St. George Hospital.
These mechanisms and therapeutic approaches are actively under scientific investigation. Treatment protocols are continuously updated as new clinical evidence becomes available.
Our Post-COVID treatment program is structured to provide maximum therapeutic benefit within a concentrated timeframe, with clear follow-up pathways for sustained recovery.
Intensive inpatient treatment program with daily therapeutic sessions and continuous medical monitoring.
Every treatment plan is designed based on each patient's specific diagnostic findings, symptom profile, and medical history.
Objective tracking of microcirculation, microclot burden, immune parameters, and mitochondrial function before, during, and after treatment.
We welcome international patients and provide multilingual coordination, airport transfers, accommodation support, and teleconsultation follow-up.
Selective removal of microclots, fibrinogen, and inflammatory lipoproteins from the blood.
Pressurized oxygen therapy for tissue repair, neurological recovery, and anti-inflammatory effects.
Interval hypoxia-hyperoxia training for mitochondrial biogenesis and metabolic restoration.
International Patient — Combined Treatment Protocol
Contact our medical coordination team to discuss your symptoms, share your medical history, and begin the process of designing your individualized treatment protocol.
