Pregnancy and iron deficiency anemia are associated with COVID-19 severity: a retrospective cohort study from Gaza

INTRODUCTION: COVID-19 poses significant risks to pregnant women, with pregnancy recognized as a risk factor for severe disease. This vulnerability may be exacerbated by iron deficiency anemia (IDA) due to impaired immune function, reduced oxygen transport, and altered coagulation and endothelial function. METHODS: = 174) groups were stratified by IDA, investigating the impact of pregnancy and IDA on the severity of COVID-19. Iron deficiency was determined by transferrin saturation levels <20% measured during acute infection, whereas ferritin levels were not available. RESULTS: = 0.003) compared with moderate illness. CONCLUSION: This study suggests that among young, otherwise healthy, unvaccinated women with COVID-19, pregnancy and IDA are associated with increased COVID-19 severity. However, interpretation requires caution considering the small number of events, particularly deaths, and the assessment of iron status during acute infection using transferrin saturation alone without ferritin measurements, which limits the ability to distinguish preexisting iron deficiency from inflammation-related changes in iron metabolism.