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For instance, reduced mtDNA copy number in subcutaneous adipose tissue is a well-documented feature of the lipoatrophy caused by older NRTIs like stavudine (d4T) and zidovudine (AZT), as mtDNA depletion impairs adipocyte differentiation and triglyceride storage

Case presentation A 38-year-old female patient (168 cm, 51 kg, body mass index [BMI] 18.1) presented to the Long Covid Outpatient Clinic in July 2022 with complex symptoms such as exercise-induced dyspnea, palpitations, thoracic burning, blood pressure dysregulations (often hypertensive), Raynauds syndrome, muscle pain, and post-exertional malaise (PEM) in temporal relation after vaccination against SARS-CoV2 and twofold infection

Cunningham et al., 2005), we hypothesize that the presence of l-alanine in the DIP or in its free form may be important for the benecial effects observed, since l-alanine can spare L-glutamine metabolism in order for the latter to be used by high-demand tissues under oxidative stress, which is not exclusively related to the working muscles, but also the liver