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The prevalence and associated factors of Post-COVID-19 fatigue: a systematic review and meta-analysis

revealed that bioactivity of BMMSCs-EXOs is reduced after storage at room temperature and 4 C, but storage at 20 C, 80 C, or lyophilization typically retains bioactivity for up to 4 weeks (Van De Wakker et al., 2022)

And as I always say, anytime you want to answer a question about kind of why something evolved to be a particular way, you have to remember that neither I nor anyone else was involved in the design phase

Disclaimer Not Evaluated by the FDA These statements have not been evaluated by the Food and Drug Administration, and sermorelin is not FDA-approved to diagnose, treat, cure, or prevent any condition outside of recognized uses