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Additionally, the oxidative stress concurrent with many pathological situations could be an important contributor to the formation of the larger amounts of AX-protein adducts observed under this type of stress and that seem involved in AX adverse reactions

That implies confidence is weak

Abstract The spike protein of SARS-CoV-2 has been found to exhibit pathogenic characteristics and be a possible cause of post-acute sequelae after SARS-CoV-2 infection or COVID-19 vaccination

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