Microclots & Fibrinoid Deposits
Abnormal amyloid-like fibrin deposits form in the blood, trapping inflammatory proteins such as serum amyloid A and alpha-2 antiplasmin, resisting normal breakdown and obstructing capillary flow.
Conditions — Post-COVID
Post-COVID Recovery
Long COVID is not simply lingering fatigue. It is a multisystem disorder involving impaired microcirculation, fibrinoid microclots, vascular dysfunction, and immune dysregulation. At St. George Hospital, we identify and treat these mechanisms directly.
- 2–3 week inpatient programme
- Video consultation before you travel
- Diagnostics: microcirculation, microclots, immune profile
- Long COVID and Post-COVID syndrome
Understanding Post-COVID Syndrome
A Multisystem Disorder with Identifiable Pathology
Post-COVID syndrome — commonly known as Long COVID — affects an estimated 65 million people worldwide. Symptoms persist for months or years after initial infection, disrupting patients’ ability to work, exercise, and carry out daily life.
At St. George Hospital in Bad Aibling, Germany, under the clinical leadership of Dr. Julian Douwes, we approach Post-COVID not as a vague collection of unexplained symptoms, but as a condition with identifiable, measurable pathology. Our diagnostic and treatment protocols are informed by the latest clinical research, including the work of Dr. Beate Jaeger, whose investigations into fibrinoid microclots and endothelial dysfunction have shaped how we understand and address the biological mechanisms driving Long COVID.
We believe that effective treatment begins with accurate diagnosis. Our program combines advanced laboratory assessment, functional microcirculation testing, immune profiling, and targeted biological therapies to address the root causes of persistent illness.
Clinical Perspective
The Microclot & Microcirculation Framework
The clinical work of Dr. Beate Jaeger at Klinik St. Georg has been instrumental in highlighting the role of fibrinoid microclots in Post-COVID syndrome. Her research points to endothelial dysfunction and impaired microcirculation as key mechanisms underlying the persistent symptoms experienced by Long COVID patients.
Microclots — abnormal, amyloid-like fibrin deposits found in the blood of Post-COVID patients — trap inflammatory molecules and impair oxygen and nutrient delivery to tissues throughout the body. When the endothelium (the lining of blood vessels) is damaged, the resulting vascular dysfunction compounds these effects, creating a self-perpetuating cycle of inflammation and hypoxia at the capillary level.
This pathophysiological framework directly informs the treatment approach at St. George Hospital. By targeting microclots through therapeutic apheresis, supporting vascular repair, and restoring adequate microcirculation, we address the condition at a mechanistic level rather than managing symptoms alone.
Note: The microclot and microcirculation model represents an important and clinically relevant research direction. These mechanisms are actively under scientific investigation, and our treatment protocols evolve as the evidence base develops.
Pathophysiology
The Biology Behind Long COVID
Current clinical evidence points to several interconnected mechanisms that sustain Post-COVID symptoms. Understanding these pathways is essential to effective treatment.
Endothelial Dysfunction
The vascular endothelium -- the single-cell lining of all blood vessels -- sustains damage from SARS-CoV-2 infection, impairing vasodilation, increasing clotting tendency, and promoting chronic inflammation.
Impaired Microcirculation
Capillary blood flow is reduced, limiting oxygen and nutrient delivery to tissues throughout the body. This microcirculatory failure contributes to fatigue, cognitive dysfunction, and organ-level symptoms.
Immune Dysregulation
Chronic immune activation, elevated inflammatory cytokines, reactivation of latent viruses (EBV, CMV, HHV-6), and emerging autoimmune phenomena sustain systemic inflammation long after viral clearance.
Mitochondrial Dysfunction
Cellular energy production is impaired at the mitochondrial level, resulting in reduced ATP synthesis, increased oxidative stress, and the profound fatigue and exercise intolerance characteristic of Long COVID.
Autonomic Dysfunction
The autonomic nervous system -- which regulates heart rate, blood pressure, digestion, and temperature -- becomes dysregulated, leading to POTS, orthostatic intolerance, and erratic vital signs.
Targeted Therapies
Our Treatment Approach
Based on the microclot and microcirculation framework, our Post-COVID treatment protocol combines targeted biological therapies to address each pathological mechanism. Treatment plans are designed by Dr. Julian Douwes and individualized for each patient.
H.E.L.P. Apheresis
Heparin-induced extracorporeal LDL precipitation removes microclots, inflammatory proteins, and fibrinogen from the blood, directly addressing the microclot burden identified by Dr. Beate Jaeger's research.
What H.E.L.P. apheresis involves →Hyperbaric Oxygen (HBOT)
Pressurized oxygen therapy saturates tissues beyond what impaired microcirculation can deliver, supporting neurological recovery, endothelial repair, and reduction of chronic inflammation.
Our hyperthermia therapies →IHHT (Interval Hypoxia-Hyperoxia)
Alternating low and high oxygen breathing stimulates mitochondrial biogenesis, improves cellular energy production, and enhances the body's adaptive capacity at the metabolic level.
What IHHT training involves →Immune Modulation Therapy
Intravenous immune support, targeted cytokine modulation, and biological immune regulation address the chronic immune dysregulation and viral reactivation that sustain Long COVID symptoms.
What immune therapy involves →Ozone Therapy
Medical ozone administration improves blood rheology, enhances oxygen utilization at the tissue level, and exerts antimicrobial and immune-modulating effects relevant to Post-COVID recovery.
What ozone therapy involves →Physical Rehabilitation
Carefully paced physical rehabilitation, respiratory training, and autonomic reconditioning are essential to rebuilding functional capacity without triggering post-exertional malaise.
Physical therapy during your stay →Post-COVID programme
Explore the programme
Symptoms & Causes
Understand the full spectrum of Long COVID symptoms organized by organ system, and the biological mechanisms -- from microclots and endothelial damage to viral persistence -- that drive them.
Long COVID symptoms and causes →Treatment Protocol
Our three-phase treatment approach: precision diagnostics, core biological therapies targeting microclots and microcirculation, and long-term recovery and resilience building.
How we treat chronic Lyme →Request a consultation
Begin with a comprehensive evaluation. We accept international patients and offer teleconsultation for initial assessment before your visit to Bad Aibling.
Request a consultation →500+Post-COVID Patients Treated
12+Therapeutic Modalities
2-3
Week Intensive Program
FREQUENTLY ASKED QUESTIONS
Common Questions About Post-COVID Treatment
How long is the Post-COVID program?
Our Post-COVID recovery program is typically 2-3 weeks, depending on the severity of your symptoms and the specific therapies included in your individualized treatment plan. Some patients benefit from a follow-up stay several months later.
What makes your approach different from other Long COVID clinics?
Our approach focuses on the measurable pathology underlying Long COVID — microclots, impaired microcirculation, endothelial dysfunction, and immune dysregulation — rather than simply managing symptoms. We use targeted biological therapies like H.E.L.P. apheresis, HBOT, and immune modulation to address these root mechanisms directly, informed by the clinical research of Dr. Beate Jaeger.
Do you treat Long COVID in children?
Yes. We treat children and adolescents with Long COVID using age-adjusted protocols. Pediatric patients are evaluated individually, and treatment plans are adapted to their specific needs and developmental stage. Our team has experience treating young patients from around the world.
What diagnostic tests do you perform?
Our diagnostic evaluation includes microcirculation assessment, microclot detection, comprehensive immune profiling, mitochondrial function testing, autonomic nervous system evaluation, inflammatory marker panels, and screening for viral reactivation (EBV, CMV, HHV-6). Additional tests are ordered based on individual clinical findings.
Can I do a remote consultation first?
Yes. We offer video consultations for international patients as a first step. This allows our medical team to review your medical history, discuss your symptoms, and determine whether our program is appropriate for your situation — all before you commit to travel.
What does the programme cost?
There is no fixed price. After our physicians have reviewed your findings, you receive an individual estimate that lists the daily inpatient rate, diagnostics and therapy blocks. Treatment is self-pay; the itemised invoice can be submitted to a US insurer for out-of-network review. We cannot promise reimbursement.
PATIENT EXPERIENCES
Recovery Stories
“Our son is back to full health. He is doing all the sport he loves, back to full time schooling and he is happier than he has ever been. He even competed at an athletics competition and broke some records and received many medals. Thank you for helping our boy get his life back. Keep up the amazing work you are doing, you are changing lives and giving children back their futures.”
International Patient’s Parent, Ireland
Post-COVID Recovery
“After 30 years of illness I feel so blessed to have been treated there. My Covid related clotting issues would never have been identified here. You guys are all amazing.”
International Patient
Combined Lyme & Long COVID Treatment
Request a consultation
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.