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E1 is a TPP-dependent -ketoacid dehydrogenase, E2 is a dihydrolipoamide transacetylase that binds one or two lipoyl groups via covalent amide linkages to lysine residues, and E3 is an FAD-containing dihydrolipoamide dehydrogenase that re-oxidizes dihydrolipoamide using NAD +

Similar patterns of severe mitochondrial impairment have been extensively documented in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)

When the body detects these pathogens, the immune system launches a massive defensive response, releasing pro-inflammatory cytokines like IL-6 and TNF- in what is sometimes called a "cytokine storm." While this inflammatory response is necessary to destroy the virus, it comes at a steep metabolic cost

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