Resumo
Objetivo: Analisar s mecanismos envolvidos na desregulação do ferro associada à COVID longa, por meio de revisão integrativa, a fim de ampliar a compreensão de seus desfechos clínicos e fisiopatológicos. Métodos: Trata-se de revisão realizada entre janeiro e outubro de 2025, com o objetivo de identificar, sintetizar e avaliar evidências referentes aos fenótipos de anemia relacionados à COVID longa, suas classificações e correlações clínicas. A pesquisa foi conduzida nas bases MEDLINE/PubMed, SciELO, Latindex e LILACS/BVS. Resultados: A análise dos estudos identificados evidenciou distúrbios hematológicos, com predomínio de anemia de inflamação, caracterizada por hiper-hepcidinemia, restrição funcional do ferro e redução da eritropoiese. Foram descritas também alterações estruturais e bioquímicas das hemácias, incluindo modificações de membrana, aumento de carboxiemoglobina e sinais compatíveis com hemólise subclínica. Essas anomalias foram associadas à redução da capacidade, fadiga e recuperação lenta. Homens e indivíduos com COVID-19 aguda grave apresentaram maior probabilidade de manter alterações hematológicas, destacando o papel da inflamação e da disfunção ferro-heme na fisiopatologia da condição. Considerações finais: A COVID longa envolve anemia e desregulação do metabolismo do ferro, reforçando a importância da monitorização laboratorial contínua e da avaliação para orientar intervenções oportunas.
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