Vandalia Health Charleston Area Medical Center’s Hematology and Medical Oncology Fellow Haris Sohail, MD; Research Scientist Jennifer Collins, PhD; Hematology and Medical Oncology Physician Amir Kamran, MD; and West Virginia University School of Medicine Student Lindsay Wilson investigated the safety and outcomes of administering intravenous iron to patients with iron deficiency anemia during acute infections, a debated subject in clinical practice.

Contrasting findings from earlier studies have led many clinicians to hesitate when considering IV iron for patients with concurrent infection and IDA, even in cases where it is clinically indicated.

To address this issue, the researchers conducted a retrospective cohort study using the TriNetX Research Network. They identified adults who were at least 18 years old from 2000 to 2024, diagnosed with both IDA and one of the following acute infections and received antibiotic therapy within two days of the infection diagnosis:

  • MRSA bacteremia
  • Pneumonia
  • Urinary tract infection
  • Colitis
  • Cellulitis
  • Bacterial meningitis

The patients were propensity-matched 1:1 based on demographics, baseline labs and comorbidities.

In the cohort of over 86,000 patients, those who received IV iron experienced notably lower mortality rates at both 14 and 90 days, as well as greater increases in hemoglobin and fewer days requiring transfusions, compared to patients who did not receive IV iron. These positive outcomes were consistent across all infection types, except for bacterial meningitis, where the small sample size may have limited the detection of significant differences.

“Intravenous iron administered during acute infection was not associated with harm and may be linked to improved survival,” Dr. Sohail said.

The strongest effects appear in the pneumonia and MRSA bacteremia groups.

“These real-world data question long-standing assumptions about iron use in infection and highlight the need for prospective clinical trials to validate the safety and potential benefit of this approach.”

The research team plans to conduct a prospective clinical trial to further investigate these findings and help guide future practice.

Dr. Sohail presented this study at the American Society of Hematology plenary session on Dec. 7. Read the full abstract on the ASH Publications website.