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In COVID-19 patients, FeRD could trigger several clinical manifestations including (i) decrease functional hemoglobin (Hb), (ii) increase cellular iron overload, (iii) release free toxic heme into the circulation, (iv) manifest hypoxemia and systemic hypoxia, (v) reduce nitric oxide (NO) synthesis, (vi) activate coagulation pathway(s), (vii) trigger ferroptosis with OxS and lipid peroxidation, and (viii) induce mitochondrial degeneration 27,146

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Based on the enrichment of antioxidants, specifically glutathione peroxidases and peroxiredoxins, in the current and prior studies 13,15,20 , we speculated that ExerVs may possess the capacity to restore redox balance and prevent muscle atrophy