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doi: 10.3389/fmicb.2018.02233 89 SongZCaiYLaoXWangXLinXCuiYet al

32 , 437446.e5 (2020)

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Viral nsp12 could alter AA metabolism (especially of the branchedchain amino acids , BCAA), while nsp12, nsp7 , and nsp8 interactions with electron transport chain (ETC) and ribosomal proteins could potentially dysregulate mitochondrial respiration 39

A plethora of PASC clinical symptoms and related metabolic impairments indicate involvement of different pathobiological mechanisms such as (i) virus-induced hypoxia/Warburg effect, (ii) iron (Fe)-redox dysregulation (FeRD), (iii) m- Dys and altered bioenergetics, (iv) oxidative stress (OxS) and cellular damage, (v) immuno-pathogenesis and hyperinflammation, (vi) autoimmunity, (vii) dysbiosis, (viii) re-activation of latent pathogens, (ix) persistent viral reservoirs, and (x) viral-hijacked host cellular factors 22,27,137,138

56: S112-S120