Positives

• In a Charite cohort of 20 post-COVID ME/CFS patients with elevated beta2 adrenergic autoantibodies, five immunoadsorption sessions reduced total IgG by approximately 79% and beta2-AR-Ab by 77%, with 70% of patients reporting meaningful improvement in physical functioning lasting up to six months PubMed.
  
  
• Earlier interim reports from the same group described the procedure as generally well tolerated with reductions in fatigue and post-exertional malaise scores in responders MDPI.
  
  

Negatives

• A rebound phenomenon was observed at one month, with GPCR autoantibodies returning to about 70% of baseline levels, and individual symptom relief did not always translate to improved health-related quality of life on follow-up PMC.
  
  

Hurdles & Side Effects

• Immunoadsorption requires central venous access, multiple apheresis sessions at specialty centers (predominantly in Germany), costs tens of thousands of dollars, and is not covered by US insurance for ME/CFS or Long COVID indications Meresearch.