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Inflammation causes low iron, which triggers long-COVID – March 2024

Iron dysregulation and inflammatory stress erythropoiesis associates with long-term outcome of COVID-19

Nature Immunology volume 25, pages471–482 (2024)
Aimee L. Hanson, Matthew P. Mulè, Hélène Ruffieux, Federica Mescia, Laura Bergamaschi, Victoria S. Pelly, Lorinda Turner, Prasanti Kotagiri, Cambridge Institute of Therapeutic Immunology and Infectious Disease–National Institute for Health Research (CITIID–NIHR) COVID BioResource Collaboration, Berthold Göttgens, Christoph Hess, Nicholas Gleadall, John R. Bradley, James A. Nathan, Paul A. Lyons, Hal Drakesmith & Kenneth G. C. Smith

Persistent symptoms following SARS-CoV-2 infection are increasingly reported, although the drivers of post-acute sequelae (PASC) of COVID-19 are unclear. Here we assessed 214 individuals infected with SARS-CoV-2, with varying disease severity, for one year from COVID-19 symptom onset to determine the early correlates of PASC.

A multivariate signature detected beyond two weeks of disease, encompassing unresolving inflammation, anemia, low serum iron, altered iron-homeostasis gene expression and emerging stress erythropoiesis; differentiated those who reported PASC months later, irrespective of COVID-19 severity.
A whole-blood heme-metabolism signature, enriched in hospitalized patients at month 1–3 post onset, coincided with pronounced iron-deficient reticulocytosis. Lymphopenia and low numbers of dendritic cells persisted in those with PASC, and single-cell analysis reported iron maldistribution, suggesting monocyte iron loading and increased iron demand in proliferating lymphocytes.

Thus, defects in iron homeostasis, dysregulated erythropoiesis and immune dysfunction due to COVID-19 possibly contribute to inefficient oxygen transport, inflammatory disequilibrium and persisting symptomatology, and may be therapeutically tractable.
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VitaminDWiki – Overview Iron Supplements and Vitamin D contains

Diseases associated with

Low iron (menstruating) High iron (males)
Anemia Anemia of chronic disease
Fibromyalgia Premature aging
Inflammatory bowel disease Atherosclerosis
Hypothyroidism Anorexia
Depression / anxiety Grave's disease
Attention deficit hyperactivity disorder Heart arrhythmia
Parkinson's disease Cancer
Neurodegenerative conditions Sideroblastic anemia
Celiac disease Nonalcoholic fatty liver disease (NAFLD).
Excess dietary fructose is a primary initiator of NAFLD,
but high iron is another culprit that triggers disease progression
Restless leg syndrome Liver damage and liver disease
Hair loss Still's disease
Muscle weakness, decline in motor skills Hemochromatosis
Mental changes and memory loss Hemophagocytic syndrome

VitaminDWiki – Iron deficiency is a cause of Vitamin D deficiency

VitaminDWiki – Iron and Vitamin D deficiencies are synergistic - April 2015

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