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Risk of bias assessment The Cochrane Collaborations risk of bias tool was employed to assess the risk of bias for each study (Reference Higgins, Altman and Gtzsche19)

The spike protein-induced endothelial cell stress could cause GRP78 overexpression and translocation, leading to cytokine production, whereby it acts as a danger associated molecular patter (DAMP) activating toll-like receptors 40