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A review of the medical examination data from 25 autistic children found that 53% of these patients had increased pyruvate levels, 76% had elevated blood lactate, in 20% of them the lactate/pyruvate ratio in fibroblasts was increased, and 42% were presented with atypical results of urine organic acid analysis [72]

In support of our work, peripheral alterations in mitochondrial metabolism 39 and myopathy 12,52 have recently been observed in patients with long COVID, but how post-exertional malaise alters skeletal muscle alterations requires further confirmation