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melanotic cyanosis does not always present as purplish or bluish on the skin, as most medical textbooks portray! Certain systemic factors can contribute to healthcare disparities that dark-skinned individuals experience. Diagnostic challenges have What is Cyanosis?
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Sex hormones can act as rhythm drivers through their nuclear receptors acting as transcription factors to initiate gene expression

Anticoagulants/Antiplatelet Drugs : If you're taking blood-thinning medications like warfarin or aspirin, combining them may increase the risk of bleeding

Jian D, Jiang D, Su J, Chen W, Hu X, Kuang Y

Pyruvate dehydrogenase activity is decreased in the peripheral blood mononuclear cells of patients with Sepsis
Tinea Versicolor: Tips for Managing

And thats going to come out one case after another as these cases are brought in every state