Is It Long COVID Or Low Iron? New Study Says It Could Be Both

A new study published in the journal Nature Immunology found that iron dysregulation may be a trigger for long COVID2.

To reach these findings, researchers monitored 214 adults who tested positive for coronavirus (SARS-CoV-2). They tracked patients' symptoms and took their blood samples for one year after that initial positive test to try to tease out patterns of long COVID.

Of the 214 people monitored, 45% went on to exhibit some long COVID symptoms. Researchers observed that many of these people had low iron levels in their blood as early as two weeks post-COVID.

The research team categorized participants into five groups based on initial COVID symptom severity: asymptomatic, mildly symptomatic, moderate without supplemental oxygen requirement, moderate with supplemental oxygen requirement, and severe with assisted ventilation.

Participants in the first two groups, who did not require hospitalization, showed lower levels of inflammation in the body and less disruption in iron levels post-COVID (so while iron levels may be a point of concern for severe COVID cases, they're not something that everyone needs to worry about).

The individuals in groups three to five, however, were more likely to report long COVID symptoms. They were also more likely to have inflammation and low iron levels months later.

Now, this isn't entirely surprising given that heightened inflammation can lead to low iron levels3 (iron-deficiency anemia). "Inflammatory anemia4" is known to present in patients with diseases that cause prolonged immune activation. It can cause symptoms including fatigue, cardiovascular trouble, impaired learning, hindered exercise performance, and memory concerns—many symptoms that are shared with long COVID. 

"Iron plays an integral role in making DNA, supporting energy production, and (most notably) shuttling oxygen around cells and tissues. Not having enough iron leads to nondescript symptoms like fatigue and lightheadedness," registered dietitian and mindbodygreen's supplements editor Molly Knudsen, M.S., RDN, previously shared.

In this new study, the same participants with low iron levels post-COVID also had increased levels of iron storage protein ferritin, which stayed high for almost 200 days after the onset of the disease, continuing to cause inflammation.

This evidence suggests that iron may be associated with long COVID, especially for severe cases. This offers a possible focus area for preventing long COVID symptoms by addressing iron at the initial disease onset. These findings also offer physicians another potential way to help patients who have partially, but maybe not fully, recovered from a severe case of COVID in the past few years.

While you can't undo the onset of COVID, you can help to address anemia in the body.