Observational Study of Intranasal IVIG in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Patients Undergoing Medical Tourism

This observational study, initiated by Healing Hope International, is designed to collect real-world data (RWD) from individuals diagnosed with Long COVID who are undergoing clinical care involving intranasal immunoglobulin (IVIG) therapy at international medical tourism sites.

Eligible participants are adults (ages 18-65) with:

Persistent Long COVID symptoms for ≥12 weeks following SARS-CoV-2 infection,

Laboratory-confirmed immunodeficiency (e.g., low IgG/IgA, poor vaccine response, or specific antibody deficiency),

Elevated inflammatory biomarkers (e.g., CRP, cytokines),

No evidence of active infection (bacterial, viral, or fungal),

No comorbid neurological conditions (e.g., multiple sclerosis, Alzheimer's disease),

No current immunosuppressive therapies.

No investigational product will be administered by the study team. All treatments are prescribed and delivered independently by licensed international clinical sites. Healing Hope International operates as the sponsor and data coordinating center. Participants' data will be collected retrospectively and prospectively from site medical records, patient-reported surveys, and third-party laboratory assessments, including genetic testing for RXRA expression (e.g., via qPCR or NGS panels).

The primary data endpoints include:

Changes in immunological biomarkers (IgG/IgA, CRP, cytokine panel),

Clinical course of Long COVID symptoms (fatigue, cognitive impairment, respiratory issues),

Quality of life measures (collected via validated patient-reported outcome instruments).

The study complies with all applicable regulations for data protection and ethical research conduct, including informed consent, HIPAA-compliant data transfer where applicable, and de-identification of personal health information. Ethical approval will be obtained from an Institutional Review Board (IRB), and partner sites may obtain parallel local or national ethics approvals.

This study also seeks to characterize the broader landscape of medical tourism for regenerative therapies by mapping treatment accessibility, safety, and patient reported effectiveness in the context of international care. It does not replace or compete with regulated clinical trials but aims to generate actionable real world insights that can guide future controlled research.

By contributing to the body of evidence around global regenerative practices, this study supports the development of international ethical guidelines, compassionate use frameworks, and collaborative trial infrastructure in complex chronic conditions.

Inclusion criteria

• Age 18 to 65 years
• Clinical diagnosis of Long COVID (symptoms persisting ≥12 weeks after SARS-CoV-2 infection)
• Laboratory-confirmed immunodeficiency, including one or more of the following:
• Low serum IgG and/or IgA
• Specific antibody deficiency
• Low pneumonia titers
• Elevated inflammatory markers (e.g., CRP, cytokines)
• No active infections at the time of enrollment (bacterial, viral, or fungal)
• Negative for Lyme disease and NMDAR antibodies
• Willingness to provide informed consent for data collection and use

Exclusion criteria

• Current or recent active infection (e.g., viral, bacterial, or fungal)
• Use of immunosuppressive therapy within the last 3 months
• Active infections: Participants with active infections, including viral, bacterial, or fungal infections, will be excluded
• Neurological disorders: Participants with diagnosed neurological disorders (e.g., multiple sclerosis, Parkinson's disease, Alzheimer's disease) will be excluded
• Immunosuppressive therapy: Participants receiving immunosuppressive therapy will be excluded
• Inability to comply with study assessments or procedures