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immune dysregulation with or without reactivation of the underlying pathogens, microbiota dysbiosis, redox abnormalities, autoimmunity, microvascular blood coagulation, endothelial and mitochondrial dysfunction as well as dysfunctional signaling in the brainstem and/or vagus nerve, this combined with risk factors such as type 2 DM, sex (mainly female), ethnicity (of Latino origin), socioeconomic factors (low income), exposure to COVID-19 reinfection, the presence of specific antibodies, connective tissue disorders, and attention deficit hyperactivity disorder, however, one-third of people with LC have no preexisting conditions identified (115)