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These effects stem from upregulated enzyme activity including 3-HSD and 17-HSD, which drive testosterone biosynthesis [9]

Genomic and meta-genomic data have revealed that co-evolution between viral and cellular genomes involves frequent horizontal gene transfer and the occasional co-option of novel functions over evolutionary time 784 , the virus-induced HMRD with PASC, is one such prime example

Acknowledgments The authors would like to thank Aouatef Bellamine, for her help with study management and Suzanne Morris, at Concrete Medical Writing, LLC, for providing medical writing support (funded by Lonza)

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