Mount Sinai launches new center for complex chronic illnesses

Mount Sinai's Department of Rehabilitation and Human Performance has announced the grand opening of the Cohen Center for Recovery From Complex Chronic Illnesses (CoRE), providing clinical care for patients with conditions such as long Lyme disease/Lyme+, long COVID, and other infection-associated complex chronic illnesses such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and Ehlers-Danlos syndrome (EDS).

Supported by philanthropy from various donors, including an inaugural gift from Beth and Joshua Nash and a naming gift from the Steven & Alexandra Cohen Foundation and, the $10-million Center is located at The Mount Sinai Hospital at 5 East 98^th Street on Manhattan's Upper East Side.

The state-of-the-art facility is equipped to handle up to 700 new patients a year. The center is also launching new research programs focusing on understanding and highlighting the key similarities and differences between people living with long COVID and long Lyme disease/Lyme+, ME/CFS, EDS, and other infection-associated complex chronic illnesses. This enhanced understanding will help clinicians and researchers at Mount Sinai develop and test novel therapies for these conditions.

With a grant from and collaboration with the PolyBio Research Foundation, the Center is also leading multiple clinical trials for promising new therapies for infection-associated complex chronic illness. One will focus on the effectiveness of using antiviral medications to treat people with long COVID. Another clinical trial will test whether the enzyme lumbrokinase can help to break down microclots found in the blood of participants with long COVID and/or ME/CFS. Past studies have shown that the formation of microclots in the blood may contribute to overall symptom severity in these patients.

"Our Center will be one of the few places in the world embedded in a major clinical institution that's able to provide outstanding care management as well as leading-edge research focused on biological discovery," says David Putrino, PhD, who will serve as the Nash Family Director of the Center for Recovery From Complex Chronic Illnesses. Dr. Putrino is also a Professor of Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai and the Director of Rehabilitation Innovation for the Mount Sinai Health System. "A crucial part of our process is that our clinicians, patients, and researchers are in constant contact and communication. This is how we plan to foster the innovative and rapid work that will drive discovery and cures for people who need solutions today."

The space has been specifically designed to create a relaxing atmosphere with natural light and soft colors to create a welcoming feel. It uses biophilic design, a concept that aims to increase connectivity to the natural environment through direct and indirect exposure to nature. This can benefit people with infection-associated complex conditions who frequently experience dysautonomia/autonomic nervous system dysfunction – a disorder that impacts the regulation of the body's psysiologic process including heart rate, blood pressure and respiration - their symptoms can be worsened by harsh lighting and bright surroundings. The Center also has infection prevention infrastructure that includes HEPA filters and germicidal far-UV light technology, which rapidly remove viruses and other aerosols from the air.

At the Center, patients will undergo specialized rehabilitation with a physical therapy team with expertise in autonomic rehabilitation to address autonomic dysfunction, which is experienced by at least 70 percent of people with infection-associated complex chronic illness. For detailed assessment of the autonomic nervous system, the Center features a next-generation patient assessment platform including postural testing, continuous blood pressure monitoring, tilt-table testing, and sudomotor testing, which helps evaluate the portion of the autonomic nervous system that controls the ability to sweat. These components have been developed specifically for the assessment of long COVID, long Lyme disease, and other chronic conditions that arise following an acute infection. After the assessment, physicians at the Center medically manage the clinical care of patients and use the latest evidence to prescribe medications that are known to be effective in the management of concurrent conditions such as latent viral reactivation and mast cell activation syndrome.

The Center will offer novel technological therapies (non-pharmacological) for chronic pain. These evidence-based approaches include virtual, augmented, and mixed reality; transcranial magnetic stimulation; and other noninvasive brain stimulation technologies. Additionally patients will have access to personalized cognitive rehabilitation for help with cognitive impairment, a common symptom of infection-associated complex chronic illnesses. The Center will also research novel therapies, including the role of multiple natural supplements in care management and the repurposing of existing antimicrobial and antiviral medications to treat evidence of persistent infections seen in people with long COVID and other infection-associated chronic conditions, as well as immunotherapies to treat dysregulation of the immune system that can commonly occur.