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Note: Clinical decisions are made on a case-by-case basis to avoid side effects like hypoglycemia

Thus, future studies are needed to better investigate the pathophysiology of thyroid dysfunction induced by COVID-19 at both molecular and clinical levels

Concurrent deficiencies in vitamin D, likely due to reduced sunlight exposure, and fluctuations in estradiol, progesterone, and DHEAS, especially among premenopausal women and extreme chronotypes, further exacerbate endocrine disruption 272

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