Upon re-examination of our human history, evolutionary perspectives, and genetics, a prevailing iron deficiency phenotype appears to have evolved to protect the human race from extinction. In this review, we summarize the evolutionary and genetic perspectives pointing towards the hypothesis that low iron mitigates infection. The presence of infection promotes the generation of resistance alleles, and there are some evolutionary and genetic clues that suggest the presence of an iron deficiency phenotype that may have developed to protect against infection. Examples include the relative paucity of iron overload genes given the essential role of iron, as well as the persistence of iron deficiency among populations in spite of public health efforts to treat it. Additional examination of geographic areas with severe iron deficiency in the setting of pandemics including H1N1, SARS, and COVID-19 reveals that areas with higher prevalence of iron deficiency are less affected. RNA viruses have several evolutionary adaptations which suggest their absolute need for iron, and this dependency may be exploited during treatment. RNA viruses pose a unique challenge to modern healthcare, with an average of 2–3 new pathogens being discovered yearly. Their overarching requirements for iron, along with human evolutionary and genetic adaptations which favored an iron deficiency phenotype, ultimately suggest the potential need for iron control in these infections.

中文翻译：

---

低铁会降低病毒的存活率：来自进化、遗传学和流行病的见解——对当前假设的回顾


重新审视我们的人类历史、进化观点和遗传学后，普遍存在的缺铁表型似乎已经进化出来，以保护人类免遭灭绝。在这篇综述中，我们总结了进化和遗传学的观点，指出低铁可以减轻感染的假设。感染的存在促进了抗性等位基因的产生，并且一些进化和遗传线索表明存在缺铁表型，这种表型可能是为了防止感染而形成的。例子包括考虑到铁的重要作用，铁超载基因相对较少，以及尽管公共卫生部门努力治疗铁缺乏症，但人群中铁缺乏症仍然持续存在。对 H1N1、SARS 和 COVID-19 等流行病背景下严重缺铁的地理区域进行的额外检查表明，缺铁流行率较高的地区受影响较小。 RNA病毒有几种进化适应性，这表明它们对铁的绝对需要，并且这种依赖性可能在治疗过程中被利用。 RNA 病毒对现代医疗保健提出了独特的挑战，平均每年发现 2-3 种新病原体。它们对铁的总体需求，以及有利于缺铁表型的人类进化和遗传适应，最终表明这些感染中可能需要铁控制。