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To date, only a limited number of studies have investigated the effectiveness of immunoadsorption. This prospective exploratory study investigates the effectiveness of immunoadsorption by assessing reductions in autoantibody levels and improvements in physical performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a prospective exploratory clinical trial, 18 patients with post-COVID syndrome and elevated levels of antibodies against \u03b21\/\u03b22-adrenergic receptors and\/or M3\/M4-muscarinic acetylcholine receptors were treated with a course of five consecutive immunoadsorption sessions. Clinical assessments, objective functional performance tests (e.g., step counters), laboratory parameters, and self-reported performance were performed during the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 15 women and 3 men were included in the study. Immunoadsorption was well tolerated. All participants showed a significant reduction in circulating antibodies against \u03b21\/\u03b22-adrenergic receptors and M3\/M4-muscarinic acetylcholine receptors; however, these levels returned to baseline within the following 3 to 6 months. Objective determinations of physical performance showed no significant improvement following immunoadsorption. Self-reported evaluation revealed a slight improvement in pain and fatigue. However, the correlation analysis failed to demonstrate a significant association between changes in autoantibody levels and subjectively perceived symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Immunoadsorption was safe and resulted in a short-term, significant reduction in measured autoantibodies. However, there were no improvements in objectively measured performance. Our results indicate that immunoadsorption is not an effective approach for patients with post-COVID syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s15010-026-02914-8","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T14:57:50Z","timestamp":1786460270000},"page":"2701-2713","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of immunoadsorption on autoantibodies and physical performance in post-COVID patients: a prospective exploratory study of 18 participants"],"prefix":"10.1007","volume":"54","author":[{"given":"Christine","family":"Wossidlo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Steinbeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilte","family":"Geerdes-Fenge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Sombetzki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Mitzner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha","family":"Loebermann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil C.","family":"Reisinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Koball","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"2914_CR1","unstructured":"World Health Organization. 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