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Background Susceptibility to the pandemic coronavirus disease 2019 (COVID-19) has recently been associated with ABO blood groups in patients of different ethnicities. This study sought to understand the genetic association of this polymorphic system with risk of disease in Iraqi patients. Two outcomes of COVID-19, recovery and death, were also explored. ABO blood groups were determined in 300 hospitalized COVID-19 Iraqi patients (159 under therapy, 104 recovered, and 37 deceased) and 595 healthy blood donors. The detection kit for 2019 novel coronavirus (2019-nCoV) RNA (PCR-Fluorescence Probing) was used in the diagnosis of disease. Results Mean age was significantly increased in patients compared to controls (49.8 ± 11.7 vs. 28.9 ± 6.6 years; p < 0.001). A similar observation was made in recovered (42.1 ± 10.4 vs. 28.9 ± 6.6 years; p < 0.001) and deceased (53.6 ± 9.7 vs. 28.9 ± 6.6 years; p < 0.001) cases. The mean age was also significantly increased in deceased cases compared to recovered cases (53.6 ± 9.7 vs. 42.1 ± 10.4 years; p < 0.001). There were gender-dependent differences in COVID-19 prevalence. The percentage of COVID-19 was higher in males than in females (all cases: 59.7 vs. 40.3%; recovered cases: 55.8 vs. 44.2%). Such male-gender preponderance was more pronounced in deceased cases (67.6 vs. 32.4%). Logistic regression analysis revealed that groups AB and B + AB were significantly associated with increased risk to develop COVID-19 (OR = 3.10; 95% CI 1.59–6.05; pc = 0.007 and OR = 2.16; 95% CI 1.28–3.63; pc = 0.028, respectively). No ABO-associated risk was observed in recovered cases. On the contrary, groups A (OR = 14.60; 95% CI 2.85–74.88; pc = 0.007), AB (OR = 12.92; 95% CI 2.11–79.29; pc = 0.042), A + AB (OR = 14.67; 95% CI 2.98–72.33; pc = 0.007), and A + B + AB (OR = 9.67; 95% CI 2.02–46.24; pc = 0.035) were associated with increased risk of death in deceased cases. Conclusions The findings of this study suggest that group AB may be a susceptibility biomarker for COVID-19, while group A may be associated with increased risk of death.

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The inheritance of autoantibodies to thyroglobulin and thyroid peroxidase (thyroid microsomal antigen) has been reevaluated with newly developed ultrasensitive assays that depend on the direct interaction between antibody and radiolabeled antigen. In a study of 16 families with autoimmune thyroid disease, autoantibodies to thyroid peroxidase (TPO) were found to be inherited as a dominant Mendelian trait in females with reduced penetrance in males. Similar results were obtained with thyroglobulin (Tg) autoantibodies. Genetic linkage analysis of the loci for TPO and Tg autoantibodies with 28 polymorphic serological markers (including HLA and Gm allotypes) was carried out in 9 families. LOD scores for some serological markers (such as Gm) were uninformative, but linkage with other markers, notably the HLA antigens -A, B, -DR, -DQ, and BF on chromosome 6, could be excluded. Further studies using a comprehensive panel of gene probes to analyze DNA from families with autoimmune thyroid disease should permit the localization of the gene cluster responsible for regulating the ability to produce autoantibodies to TPO and Tg in man.