Could Low Iron Levels Account For Long COVID Symptoms?

●     Although we got rid of COVID-19, for some people, its effects still exist in the form of long COVID.

●     Long COVID can have a significant impact on one’s daily life as its symptoms can include fatigue, brain fog, and digestive problems.

●     While the exact cause is unknown, research has indicated a strong link between disturbance in iron levels during COVID-19 and long COVID.

●     The study findings propose new approaches for managing and treating long COVID.

In mid-February of this year, the World Health Organization (WHO) reported nearly 775 million COVID-19 cases worldwide.

Most of the time, the virus that causes COVID-19, known as SARS-CoV-2, leads to mild sickness. However, in some cases, it can be severe, requiring hospital care, and, in extreme situations, can even cause death.

Even after recovering from the initial sickness, some people face long-term effects known as long COVID. Studies suggest that about 10% of those who get sick with the virus might develop long COVID, and a significant number of patients who were hospitalised continue to have symptoms.

Fatigue, exhaustion after physical activity, difficulty breathing, chest pain, confusion, trouble sleeping, and digestive problems are the symptoms of long COVID.

Currently, researchers are still determining why people develop long COVID. A recent study has indicated that changes in iron levels during the first bout of the illness might be connected to the long COVID symptoms.

An expert from the Johns Hopkins Bloomberg School of Public Health explained that the study found changes in how the body handles iron in people with long COVID, including lower iron in the blood. This isn't surprising since long COVID involves ongoing inflammation, often leading to decreased iron levels.

Why There Is A Need To Check Iron Levels After COVID?

The researchers noticed that many of the long COVID symptoms looked like what happens when someone doesn't have enough iron, a condition known as iron-deficiency anaemia. So, they decided to explore how the COVID-19 virus might affect the body's iron management.

They studied 214 people who had caught the virus and followed them for a year after getting sick. The severity of their COVID-19 ranged from no symptoms at all to very severe cases that needed breathing support.

The study participants were put into five groups based on how serious their COVID-19 symptoms were:

●     No symptoms

●     Just a few mild symptoms

●     Moderate symptoms but didn't need extra oxygen

●     Moderate symptoms and did need extra oxygen

●     Very sick and needed help breathing

The ages of the participants varied from 17 to 89, with those in the more severe groups tending to be older. The people in the more severe groups (3 to 5) had all been hospitalised at some point during their illness, while those in the first two groups had not.

The researchers collected and compared blood samples from these participants at different times, up to 352 days after they first showed symptoms or tested positive for the virus (for those who didn't have symptoms). They also compared these samples to ones from people who had never had COVID-19.

The study found that COVID-19 messed with the immune system in many ways, and this effect lasted the longest in people with the most severe symptoms. In those who ended up in the hospital, the researchers noticed that when the illness was at its worst, there was a lot of inflammation in the body. This inflammation messed with how the body handles iron, which is important for health.

This problem with iron was shown by high levels of a hormone called hepcidin, which helps regulate iron. Because of this, the amount of iron in the blood dropped. At the same time, the body was storing more iron in a protein called ferritin, which stayed high for up to 180 days after getting sick. This showed that inflammation was still occurring, and the body was holding onto iron instead of using it properly.

The lowest iron levels were seen when people were sick and in those who had the hardest time recovering, with their iron levels staying low for up to 270 days after they first got sick.

When there's not enough iron available, it affects haemoglobin, which is the part of red blood cells that carries oxygen around the body. People who were sick had haemoglobin levels that were still low even 90 days after they got better.

This situation, where there's low iron in the blood but high iron storage and inflammation, is similar to inflammatory anaemia. This condition can make people feel really tired and weak, mess with heart health and how well you can exercise, and even affect learning and memory.

People with mild or no symptoms didn't show these problems with iron or inflammation.

An expert doctor commented that the issues with iron levels and regulation started early during the infection and took a long time to get back to normal, especially in those who developed long COVID. Even though the body tried to fix the low iron and the resulting anaemia by making more red blood cells, it wasn't very successful because of the ongoing inflammation.

Implications For Long COVID Treatments

When our body fights off infections, it often moves iron out of the bloodstream. This is a defence strategy to ensure harmful germs don't get the iron they need to grow. But, if this immune reaction goes on for too long, it can lead to a shortage of iron for red blood cells. This is what happens in anaemia and also occurs in many people who are dealing with long COVID.

The main issue is that there needs to be more iron in the body overall. The problem is that the iron needs to be somewhere else. The iron is locked away and can't reach the required red blood cells.

What's needed, then, is a way to get that iron back into the bloodstream where it can be useful again. However, adding more iron to the body isn't necessarily the solution because having too much iron can also be harmful.

The research suggests that some long COVID symptoms might be due to how iron is managed in the body. But people with long COVID shouldn't just start taking iron supplements, thinking it'll fix everything. Too much iron isn't good either. Talking to a doctor to see if adding iron to your diet is a good idea is important.

This research opens a new path to understanding long COVID, especially iron's role. However, figuring out how to use this information to help patients will need more studies.

Mobi Doctor can offer advice and guidance if you're experiencing iron levels and long COVID symptoms.

Our team can help you understand your symptoms and discuss the best steps to take for your health.