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The WHO estimates it affects between 1020% of people infected with SARS-CoV-2 tens of millions globally.1 The symptoms are wide-ranging but cluster into recognizable patterns: Neurological: brain fog, cognitive impairment, headaches, sleep disruption Cardiovascular: chest pain, breathlessness, tachycardia (POTS), reduced exercise tolerance Immune: persistent low-grade inflammation, recurrent infections, autoimmune flares Musculoskeletal: post-exertional malaise (PEM), joint pain, muscle weakness Metabolic/endocrine: insulin dysregulation, thyroid disruption, adrenal fatigue signals Standard care rest, symptom management, antidepressants, rehabilitation programs helps some patients

Methylcobalamin Cyanocobalamin : Synthetic, contains a cyanide molecule, requires liver conversion before use

It may turn from red-purple to blue-gray over a few days, eventually leading to skin breakdown in 3-5 days

Neurologically, ALD/AMN can manifest with highly variable phenotypes, ranging from very aggressive and rapidly fatal inflammatory CNS demyelination in young boys to a more slowly progressive adult form either with cerebral white matter inflammatory lesions, or a more indolent progressive myelopathy and peripheral neuropathy (Moser, 1997)