Revisiting the impact on mortality of intravenous iron administration during acute inpatient infections

The safety of iron repletion during acute infections has long been debated. A recent retrospective analysis reported significant and rapid mortality benefits from inpatient iron infusions given to patients with acute infections. This potential paradigm shift in inpatient management of iron deficiency anemia puts into question whether current common practice of withholding iron during infections is not only unnecessary, but actively harming patients. Our analysis utilizing the same database but with adjustments for additional confounders largely identified no difference in mortality in hospitalized patients with iron deficiency anemia who survived at least 7 days after being admitted for an infection, and suggests further studies are needed to truly clarify the safety and role for intravenous iron during acute infections.