3Discussions
143 minAnalysed
Last reviewed: Jun 7, 2026·Credential: PhD, Director of Rehabilitation Innovation (Mt. Sinai)·First indexed: Jun 7, 2026
About the expert
Focus: Pioneering clinical treatment protocols for Long COVID grounded in dysautonomia rehabilitation, with strong patient-collaboration emphasis
Director of Rehabilitation Innovation at Mount Sinai Health System and founder of one of the largest Long COVID clinics in the US (the Mt. Sinai Center for Post-COVID Care). Pioneered a three-phase Long COVID rehabilitation protocol: symptom stabilization, breathwork-based 'prehab', then gentle low-intensity autonomic exercises designed to avoid post-exertional malaise. Leverages existing dysautonomia treatment frameworks adapted for Long COVID. Strong advocate for patient-centered research where patient lived experience shapes clinical protocols. Mainstream rehabilitation medicine credentials with Long COVID clinical leadership.
Expert discussions with Dr. David Putrino
Putrino: How Mt. Sinai treats Long COVID, phase by phase
Mt. Sinai runs one of the largest Long COVID clinics in the US. Treatment takes persistent symptoms seriously even when standard tests look normal. The protocol has three phases: stabilize symptoms, add breathwork, then slowly rebuild activity without crashes.
Putrino: Long COVID vs Functional Neurological Disorder, and why the distinction matters
Long COVID is sometimes classified as Functional Neurological Disorder (FND). The argument presented here is that Long COVID may involve mechanisms being actively investigated (viral persistence, inflammation, autonomic dysregulation) that may not be captured by an FND framework. The classification affects diagnosis, insurance, treatment access, and how seriously symptoms are taken.
Putrino + Nath: A vagus nerve stimulation trial result and the case for combination therapy in Long COVID
A randomized controlled trial of vagus nerve stimulation (VNS) for Long COVID missed its primary endpoint, but physiological data suggests higher doses or combination with medications like famotidine may still help some patients with autonomic dysfunction. Persistent viral remnants and immune exhaustion appear to drive vascular damage and brain inflammation in many cases. The complexity of Long COVID likely requires personalized combination therapies rather than a single cure.