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Furthermore, increased ACE2 expression in alveolar type II pneumocytes and alveolar macrophages of individuals with severe SARS-CoV-2 disease (ARDS with diffuse alveolar damage) requiring mechanical ventilation (Baker et al., 2021) favors a concomitant increase in oxidative stress in those individuals

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Identify gaps in the literature and ongoing research directions Key gaps include a lack of large, controlled clinical trials, unclear optimal dosing and delivery for reproductive targets, limited long-term safety data for systemic use, and few mechanistic human studies linking molecular changes to fertility outcomes