I have read ongoing discussion of whether patients
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This does not seem to be a settled issue, even among the physicians and researchers.
In my mind, it appears that this may be similar to the claims of "chronic Lyme", where the symptoms are more likely autoimmune without ongoing Borrelia activity.
I would put my money on continued immune dysfunction. I'll be waiting like the rest to see the impact of Leronlimab and other immune modulators in the continued unwell post-covid population.