Clinicians involved in long Covid care have expressed concern about unproven and potentially high-risk purported treatments for long Covid, which patients may be accessing in Ireland or abroad.
Internationally, some of the hypotheses for the underlying mechanisms of long Covid have developed into unproven treatment-based approaches, stated Prof Seamus Linnane, Consultant Respiratory Physician at the Beacon Hospital in Dublin, where he leads the post- Covid clinic.
These unproven approaches included aggressive anticoagulation regimens, immunotherapy, and high-dose steroid regimens, all of which lacked an evidence-base for long Covid treatment and may have potentially serious side-effects.
Prof Linnane said the clinic has had patients who have been recommended high-dose anticoagulation and immunotherapy regimens abroad. “They have come to us and asked for our opinion and we have not supported [these regimens],” he told the Medical Independent.
“Certainly, we would be very nervous about the very high-dose anticoagulation regimens that are recommended internationally, and it seems to be more an international issue for the anticoagulation regimen.”
He said a triple drug anticoagulation regimen is of proven benefit for well-defined cardiovascular conditions, but equally has a well-described adverse haemorrhage rate per year, which is an unacceptable risk for a relatively young cohort in the absence of supportive data.
Dr Stefano Savinelli, Consultant in Infectious Diseases at St Vincent’s University Hospital, Dublin, who leads the long Covid service at the hospital, said the “most concerning” issue was use of anticoagulants and antiplatelet agents for long Covid. There was “absolutely zero evidence” for their use in long Covid and the potential risks were “substantial” due to the risk of life-threatening haemorrhage events, with severe potential outcomes including death or permanent disability.
Dr Savinelli said he was aware of a patient who had travelled to Germany where they were prescribed a combination of two different anti-platelet agents and one anticoagulant for eight weeks. “I haven’t heard of anticoagulants being used in Ireland so far,” he added.
Currently there are no established evidence-based treatments specifically for long Covid.
See news feature, At the coalface of Ireland’s long Covid care – Medical Independent