Rosenheimer Str. 6-8, 83043 Bad Aibling, Germany · info@clinicum-stgeorg.de
Post-COVID Diagnostics
Identifying the specific mechanisms driving your long COVID symptoms through advanced microvascular, immunological, and metabolic testing that standard workups miss.
You had COVID, and eighteen months later you still cannot climb the stairs without your heart racing. Your primary care doctor ordered the standard panel and found nothing. The Long COVID clinic has a waitlist longer than your patience.
This page lists what we measure for Post-COVID and Long COVID, why those tests, and what the results tell us.
One of the most frustrating experiences for long COVID patients is receiving “normal” results from conventional blood work while continuing to suffer debilitating symptoms. This disconnect is not because the symptoms are imaginary. It is because standard diagnostic panels are not designed to detect the specific pathological mechanisms that drive post-COVID syndrome.
Research has increasingly shown that long COVID involves microvascular dysfunction (impaired blood flow in the smallest vessels), persistent immune activation, microclot formation, endothelial damage, mitochondrial impairment, and neuroinflammation. These processes are largely invisible to routine blood counts, metabolic panels, and standard imaging.
At St. George Hospital, our post-COVID diagnostic workup is specifically designed to evaluate these mechanisms. Building on the pioneering work of Dr. Beate Jaeger on microvascular dysfunction, we use advanced testing to identify exactly which pathological processes are active in each patient, enabling truly targeted treatment.
Dr. Beate Jaeger has been at the forefront of research into microvascular dysfunction in post-COVID syndrome. Her work has demonstrated that impaired microcirculation, often undetectable by conventional imaging, is a central driver of persistent fatigue, cognitive dysfunction, exercise intolerance, and organ-level symptoms in long COVID patients.
Microclots, or fibrin amyloid microclots, are abnormal clot formations in the microvasculature that resist normal fibrinolysis. These microclots impair oxygen and nutrient delivery to tissues, contributing to the multi-organ symptoms characteristic of long COVID. Dr. Jaeger’s diagnostic and therapeutic protocols specifically target this mechanism.
Her findings align with growing international research confirming that endothelial damage, platelet activation, and impaired fibrinolysis play central roles in post-COVID pathology, and that these mechanisms require specific diagnostic approaches to detect and specific therapeutic approaches to resolve.
Our comprehensive post-COVID evaluation covers five major domains to identify the specific mechanisms driving your symptoms. Each test category provides actionable information that directly informs treatment selection.
Functional microcirculation assessment using capillaroscopy and perfusion measurement to evaluate the health and function of the smallest blood vessels. This reveals impaired microvascular flow that conventional vascular imaging cannot detect, and is essential for understanding exercise intolerance and organ-specific symptoms.
Specialized fluorescence microscopy and coagulation analysis to identify fibrin amyloid microclots that persist in the blood of many long COVID patients. We assess D-dimer, fibrinogen degradation products, and platelet activation markers alongside direct microclot visualization to quantify clot burden and guide anticoagulant therapy.
Comprehensive immune panel including lymphocyte subsets (CD4, CD8, NK cells), T-cell activation markers, cytokine profiles (IL-6, TNF-alpha, IL-1beta, IL-10), autoantibody screening, and complement activation. This identifies whether persistent immune activation, immune exhaustion, or autoimmune mechanisms are contributing to symptoms.
Evaluation of mitochondrial function through organic acid testing, lactate/pyruvate ratios, CoQ10 levels, and oxidative stress markers (glutathione, MDA, 8-OHdG). We also assess NAD+ status, B-vitamin levels, and metabolic efficiency to identify energy production impairments driving fatigue and exercise intolerance.
Assessment of autonomic nervous system function (heart rate variability, tilt-table testing where indicated), neurocognitive screening, and neuroinflammatory markers. Many long COVID patients experience dysautonomia, brain fog, and cognitive impairment linked to neuroinflammation and microvascular dysfunction in the central nervous system.
Endothelial function testing, von Willebrand factor, ADAMTS13, soluble thrombomodulin, and vascular inflammation markers. Endothelial damage is a hallmark of COVID-19 and persists in many long COVID patients, driving both microvascular and larger-vessel dysfunction that contributes to multi-organ symptoms.
Our post-COVID diagnostic workup is typically completed over 1–2 days, allowing us to gather comprehensive data and develop a targeted treatment plan efficiently.
Detailed review of your COVID history, symptom timeline, prior treatments, and current functional status. We use standardized symptom scoring to track severity and monitor improvement.
Blood draw for the full diagnostic panel including microcirculation markers, immune profiling, coagulation analysis, metabolic assessment, and inflammatory markers.
Microcirculation assessment, autonomic function testing, and any additional organ-specific evaluations indicated by your symptom profile.
Detailed review of all findings with your treating physician. We explain which mechanisms are active in your case and how they connect to your specific symptoms.
Based on your diagnostic results, we develop a targeted treatment protocol addressing the specific pathological mechanisms identified, with clear goals and monitoring milestones.
Complete overview of our post-COVID treatment program including symptoms, causes, and our integrative approach.
Detailed information about our treatment protocols including apheresis, immune modulation, and microvascular therapy.
Post-COVID fatigue shares mechanisms with CFS/ME. Learn about our targeted approach to persistent fatigue.
When diagnostics reveal microclots and elevated inflammatory markers, apheresis filters these directly from the bloodstream.
What H.E.L.P. apheresis involves →Imaging and functional testing that reveals tissue hypoxia guides HBOT protocols to restore oxygen delivery to affected organs.
What a hyperbaric oxygen session involves →Mitochondrial testing results inform IHHT protocols designed to regenerate cellular energy capacity damaged by COVID-19.
What IHHT training involves →Immune panel results guide targeted immune modulation to restore balanced immune function after COVID-related dysregulation.
What immune therapy involves →A video consultation in English before you travel. A physician reviews your findings first; we reply by email within one business day (Mon–Fri).
Mon–Thu 08:00–17:00, Fri 08:00–14:00 (CET/CEST)+49 8061 398-0info@clinicum-stgeorg.de
St. George Hospital is a specialist hospital, not an emergency department. In a medical emergency in Germany, dial 112.
