BAL Spotlights Series
In this episode of Ticktective, Dana Parish interviews David Putrino, PhD, about the new Cohen Center for Recovery From Complex Chronic Illnesses at Mount Sinai which will focus on the treatment and study of Long COVID, chronic Lyme, and ME/CFS. Dr. Putrino begins by stressing the importance of complete assessment and individualized treatment for complex chronic conditions. He emphasizes the need for improved medical student and provider education to better understand and treat these illnesses.
“Death is not the only serious health outcome from COVID. An acute SARS-CoV-2 infection can absolutely rob you of your previous life as effectively as a severe infection that ends in death as anything else.”
– David Putrino
Putrino addresses the early COVID epidemic and the eventual identification of Long COVID. He discusses Long COVID’s viral persistence and inflammation and therapeutic approaches targeting endothelial dysfunction and platelet hyperactivation. The medical profession’s intractable denial and skepticism concerning these chronic diseases and the need for new diagnostic tools and research funding are also addressed.
Pandemic Shone a Light on Chronic Conditions
Parish and Putrino explore how the COVID-19 pandemic led to the development of protocols and assessments to understand and manage the disease. The term “Long COVID” was coined to describe the long-term effects and symptoms experienced by patients post-recovery. Putrino notes that understanding the pathobiology and chronic conditions associated with COVID-19 is crucial for effective diagnosis and treatment. He enumerates the serious effects of SARS-CoV-2 on humans including cardiovascular symptoms, cognitive function challenges, and post-stroke symptoms, necessitating early intervention strategies.
“Long COVID does not appear to discriminate. It doesn’t seem to care if you were in peak physical condition or if you had multiple comorbidities. We’re seeing it across the board and we’re still seeing it now in 2023. We have people coming in, they had their third COVID infection, they got over their first two, no problems at all, and now they’re unable to recover.”
– David Putrino
Pathogen Persistence is a Fact
Parish and Putrino then also point out the impact of COVID-19 on individuals with existing autoimmune diseases and talk about how this is being studied, highlighting the need for tailored approaches to each individual patient. There is a discussion about how research to prevent Long COVID and how to manage its symptoms is ongoing using substances like Nattokinase and Pycnogenol. Emphasis is placed on proof of persistence of the virus in some patients and Putrino stresses that this has been irrefutably established, leading to the classification of different Long COVID subtypes.
How the US Funds Science Needs a Shake-Up
Towards the end of the interview, Putrino talks about the challenges in obtaining research grants and the barriers to implementing innovative solutions, prompting an exploration of the NIH playbook. He shines a light on how the NIH often rejects innovative projects, preferring to fund incremental ideas and discovery over the potential for immediate results. He suggests that Congress should fund groups like DARPA, ARPA-H, and PCORI to test innovative ideas.
“The national average of bench to bedside in the United States based on NIH funding is 17 years.”
– David Putrino
The conversation closes with Putrino emphasizing the limitations of the existing research process and the need for faster and more disruptive innovation in Long COVID and infection-associated chronic disorders. He also highlights initiatives to repurpose medications and find new treatments for Long COVID and other infection-associated chronic diseases.
Detailed topics discussed include Dr. Putrino’s experiences and observations on:
- Early days of the COVID-19 pandemic
- Developments of a comprehensive assessment protocol for COVID-19 patients
- The coining of the term “Long COVID”
- Long COVID experience and symptoms
- Post-COVID stroke symptoms and early intervention
- COVID-19 impact on patients with a history of autoimmune diseases
- Emerging evidence on Long COVID prevention
- Cardiovascular symptoms and Long COVID
- Cognitive function and test limitations in Long COVID
- The use of nattokinase and pycnogenol in Long COVID symptom management
- Pathobiology and chronic conditions including rapid clustering of Long COVID endotypes
- That dysautonomia, persistent pathogens, and viral persistence is a fact
- The evolution of functional neurological disorder (FND) diagnosis
- Understanding infection-associated complex chronic illnesses
- Challenges of NIH grants and how incremental innovation hampers discovery
- The NIH playbook and insights on clinical trials
- The future of antiviral therapy
- How existing medications are being repurposed and tested for Long COVID and other infection-associated complex chronic illnesses
David Putrino is a physical therapist with a PhD in Neuroscience. He is currently the Director of Rehabilitation Innovation for the Mount Sinai Health System, and a Professor of Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai. He develops innovative rehabilitation solutions for adults and children in need of better healthcare accessibility, and in 2019, he was named “Global Australian of the Year” for his contributions to healthcare. Since the beginning of the COVID-19 pandemic in 2020, David has been recognized globally as a leading expert in the assessment, treatment, and underlying physiology of Long COVID. His team has managed the care of over 3000 people with Long COVID and published multiple peer-reviewed scientific papers on the topic.
This blog is part of our BAL Spotlights series. It is based on a recorded interview from Ticktective, our podcast and video series. To listen or watch the original conversation (1:24), click here. Bay Area Lyme Foundation provides reliable, fact-based information so that prevention and the importance of early treatment are common knowledge. For more information about Bay Area Lyme, including our research and prevention programs, go to www.bayarealyme.org.
Long.covid… CFS…Fibromyagia are new attempts to qualify chronic illness after major infections like EBV and sister Strsins, and more defined illnesses like Polio which was called post polio syndrome.
Most older Doctors called these chronic lingering illnesses after infections myalgic Encephmyalitis. This proved to wise because it Iincluded more than fatigue in name and highlighting pain and neurological symptoms and clinical findings.
CFS researchers took years to move towards pain and neurological findings. Now it is a major part of CFS Fibro clinical findings….40 years after the CDG paper in about 1985 -87 and others qualified fatigue as the hallmark of lo g term lingering illness.
Should we re -recognize the term myalgic Encephmyalitis because of its accuracy and wisdom of the older less technically dependent researchers and doctors and more experienced in Clinical work ups and wisdom that can be could be married wiith technological testing and findings.
I vote for myalgic Encephmyalitis. !!!