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What is driving that
The binding of the SARS-CoV-2 spike glycoprotein with ACE2, which triggers the virus-mediated cellular uptake, can also cause a burst of inflammatory cytokine release (a cytokine storm) partially because of the decreased availability of functional ACE2
The dosing regimen varies depending on whether neurological symptoms are present: With neurological involvement: 1 mg intramuscularly on alternate days until no further improvement, then 1 mg every 2 months [3] [4] Without neurological involvement: 1 mg intramuscularly three times a week for 2 weeks, then 1 mg every 2-3 months for maintenance [3] [4] There is some evidence that high-dose oral B12 (1000-2000 micrograms daily) may be effective even in some malabsorption conditions, though UK practice still generally favours intramuscular treatment in these cases
10.26480/msm.01.2017.30.33 2 Afkhami-ArdekaniM.Kamali-ArdekaniA.Shojaoddiny-ArdekaniA
