Infection-associated chronic illnesses (IACIs) such as long COVID, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and long Lyme disease are disabling, costly, and often misunderstood in medicine. Millions of people worldwide live with these conditions, which are difficult to diagnose due to the absence of definitive biomarkers and complex symptom profiles. Despite rising cases, knowledge gaps and stigma persist, leaving many patients without adequate care. To address these challenges, a new resource has been created to equip clinicians with evidence-based practices and improve patient outcomes.

Mount Sinai Health System (New York, NY, USA) has introduced the first clinical manual in the US for treating IACIs, developed by the Cohen Center for Recovery from Complex Chronic Illnesses (New York, NY, USA). The guide incorporates extensive learnings from the Center’s clinical care and research programs, which lead trials for promising therapies and investigate the similarities and differences among patients with these conditions. The manual provides comprehensive instruction on diagnosis, long-term management strategies, multidisciplinary care models, and effective patient communication.

Drawing from the Center’s infrastructure and treatment approaches, the manual details infection prevention protocols such as the use of HEPA filters and germicidal far-UV light technology to minimize exposure during in-person visits. It also outlines physical therapy guidelines for conditions including Ehlers-Danlos syndrome, dysautonomia, and craniocervical instability. Importantly, it warns against incorrectly prescribed cardiovascular exercise, which may harm patients experiencing post-exertional malaise.

The manual covers the care of common manifestations like brain fog, mast cell activation, and post-exertional malaise, while also presenting a molecular-level perspective on the biological processes behind diverse clinical presentations. These insights help explain why certain symptoms arise and provide clinicians with tools to develop targeted care strategies.

Reviewed by more than a dozen national and international experts, the manual ensures global relevance and practical usability. Going forward, Mount Sinai plans to support clinicians worldwide by making the manual freely accessible online. In addition, the Center will provide supplementary resources such as CME-accredited courses, events, and educational programs to strengthen adoption.

“Infection-associated chronic illnesses remain disabling, costly, and widely misunderstood across much of medicine,” said Raven Baxter, PhD, Director of Science Communication at the Cohen Center for Recovery from Complex Chronic Illnesses at Mount Sinai. “Recent research from our team shows that even a single well-designed educational intervention can dramatically increase clinicians’ confidence, preparedness, and empathy in managing these conditions.”

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