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Serious complications, whether or not related to CMV reactivation, constitute a highly likely cause of death.22 Elderly patients, with comorbidities, in poor health, in which systemic manifestations are more evident, in whom the causative medication has been perpetuated for a longer time, or in whom specific treatment has been delayed tend to have a worse prognosis and slower recovery.8285 Systemic autoimmune sequelae can appear months and even years after resolution, such as autoimmune thyroiditis, fulminant type I diabetes, autoimmune hemolytic anemia and alopecia

The gut microbiome directly influences dopamine, GABA, and other neurotransmitter production

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Side-effect trends mirror this split MT-1 reactions stay skin-focused, whereas MT-2 extends into systemic responses