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The Annals of Thoracic Surgery

This mitochondrial failure is the direct biochemical driver of the profound, debilitating fatigue and post-exertional malaise (PEM) that patients experience after even minor physical or cognitive exertion

APOE 4 Associates with Increased Risk of Severe COVID-19, Cerebral Microhaemorrhages and Post-COVID Mental Fatigue: A Finnish Biobank, Autopsy and Clinical Study

Ninety percent of Americans use caffeine daily and 50% of those people are getting at least 300mg a day (About Caffeine, n.d.)

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PMID 22313097