Iron deficiency anaemia (IDA) is a condition where a lack of iron in the body leads to a reduction in the number of red blood cells. Iron is used to produce red blood cells, which help store and carry oxygen in the blood. If you have fewer red blood cells than is normal, your organs and tissues won’t get as much oxygen as they usually would. Worldwide, around 1 billion people are thought to suffer from IDA. This results in symptoms such as fatigue, weakness, dizziness and shortness of breath, among others. Recent research has also found that low iron levels may result in more severe COVID-19 infection and contribute to symptoms of ‘long COVID’.
Treatment for IDA includes increasing the amount of iron in your diet, but often iron tablets are required. Iron tablets can take up to 3 months to work and many patients experience unpleasant side-effects such as nausea and constipation. Intravenous (IV) iron, when iron is directly administered into a vein through a drip, is increasingly being used as a treatment. This is usually done over 30 minutes, in a medical facility such as a hospital or outpatient clinic. It can boost iron levels quickly meaning patients start to feel better sooner. Although it is generally very safe, there are some concerns that IV iron may cause infection. On rare occasions, fluid can leak out of the cannula (the needle that goes into your vein) during the infusion. If this happens, it could cause long-term or even permanent discolouration or staining of your skin.
Our overall aim is to know more about how COVID-19 has impacted the management of IDA, particularly during the height of pandemic when it would have not been feasible to come to hospital for IV iron. We also want to know whether iron prescribing patterns were different in certain groups such as male and female, those from ethnic minority or socioeconomically deprived, and if they had more long-term medical conditions. We need to know more about the risks of infection and permanent skin staining after IV iron. By analysing detailed linked electronic health records over a six-year period (2019-2024), we will uncover new insights on how iron is prescribed and a better understanding of the safety profile, which have not been previously possible in smaller studies.
A deeper look into the prescribing patterns of iron therapy and the impact of COVID-19, including by patient demographics and clinical characteristics, will provide new insights on how to optimise treatment of IDA in the NHS in England. We will also provide important safety data on infection and permanent skin-staining following administration of IV iron.