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Acknowledgements We would like to thank Jasleen Jolly, Aislin Sheldon, Hannah Willis and Junaid Hameed for reading through an initial draft of the manuscript

Studies show: Elevated IL-6 and TNF- Persistent interferon signatures T-cell exhaustion Altered CD4/CD8 ratios Increased autoantibodies, including anti-nuclear antibodies (ANA) and anti-phospholipid antibodies 5 There is also growing evidence of microglial activation in patients with neurocognitive symptoms, suggesting ongoing neuroinflammation