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Table 2)

Viruses alter redox balance within infected cells leading to inflammation and tissue damage

Indeed metformin inhibits the mitochondrial oxidative phosphorylation complex I, leading to increased cellular AMP levels and subsequent stimulation of AMPK, an enzyme that plays key roles in the regulation of cellular energy homeostatis

Future research is warranted to validate proposed treatment algorithms, refine clinical subtypes of CHE, and explore long-term efficacy of emerging therapies [5, 66, 75, 107]
