Introduction: A small proportion of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) become critically ill. Individuals’ blood group may influence their susceptibility to infection. However, the relationship between blood groups and clinical outcomes in severe Coronavirus disease 2019 (COVID-19) is not well established. Therefore, we conducted a study to investigate the association between blood groups and clinical outcomes in critically ill COVID-19 patients. Methods: We retrospectively analyzed electronic health records of COVID-19 patients admitted to intensive care units (ICUs) at Hazm Mebaireek General Hospital, Qatar, from March 7th, 2020, to July 15th, 2020. The study population was divided based on their blood groups into types A, B, AB, O, Rhesus (Rh)-positive, and Rh-negative. The primary outcome studied in each blood group was all-cause ICU mortality. Secondary outcomes evaluated were the requirement and duration of mechanical ventilation, ICU days, hospitalization days, and C-reactive protein (CRP) value on admission. Results: Eight hundred forty-eight patients were admitted to ICUs with severe COVID-19 during the study period. All-cause ICU mortality in the study population was 19.8% (168/848), and that in individuals with blood groups A, B, AB, O, Rh-positive, and Rh-negative was 22.6% (52/230), 18.1% (44/243), 22% (18/82), 18.4% (54/293), 20.4% (165/810), and 7.9% (3/38). Although the highest mortality was noted in blood group A, followed by AB, these observations failed to achieve statistical significance. Rh-negative blood type had lower odds of death compared to the Rh-positive one (odds ratio = 0.27; 95% confidence interval 0.08–0.99, P = 0.049). None of the blood groups showed an association with the need for mechanical ventilation, duration of mechanical ventilation, duration of ICU and hospital stay, and CRP value on admission. Conclusion: This study revealed no association between ABO blood groups and unfavorable clinical outcomes in critically ill COVID-19 patients. The Rh-negative blood type was associated with slightly lower odds of death compared to the Rh-positive one.

Background: Timely identification of patients at risk of worse clinical outcomes is vital in managing coronavirus disease 2019 . The neutrophil-tolymphocyte ratio (NLR) calculated from complete blood count can predict the degree of systemic inflammation and guide therapy accordingly. Hence, we did a study to investigate the role of NLR value on intensive care unit (ICU) admission in predicting clinical outcomes of critically ill COVID-19 patients.Methods: We conducted a retrospective analysis of electronic health records of COVID-19 patients admitted to ICUs at Hazm Mebaireek General Hospital, Qatar, from March 7, 2020 to July 18, 2020. Patients with an NLR equal to or higher than the cut-off value derived from the receiver operating characteristic curve were compared to those with an NLR value below the cut-off. The primary outcome studied was all-cause ICU mortality. The secondary outcomes evaluated were the requirement of mechanical ventilation and ICU length of stay (LOS).Results: Five hundred and nineteen patients were admitted to ICUs with severe COVID-19 infection during the study period. Overall, ICU mortality in the study population was 14.6% (76/519). NLR on ICU admission of ≥6.55 was obtained using Youden's index to predict ICU mortality, with a sensitivity of 81% and specificity of 41%. Mortality was significantly higher in patients with age ≥60 years (p < 0.001), chronic kidney disease (p = 0.03), malignancy (p < 0.002), and NLR ≥ 6.55 (p < 0.003).There was also a significant association between the requirement of mechanical ventilation (34.7% vs. 51.8%, p < 0.001) and increased ICU LOS (8 vs. 10 days, p < 0.01) in patients with ICU admission NLR ≥ 6.55. Conclusion:Higher NLR values on ICU admission are associated with worse clinical outcomes in critically ill COVID-19 patients.

The novel Coronavirus (COVID-19) is one of the most recent Pandemics that invaded the earth and is still active. It caused and is still causing hundreds of thousands of patients high morbidity and mortality rates, with no definitive cure at this moment. COVID-19 has been proven to be associated with pathologic changes in coagulation, characterized by either thromboembolic or bleeding events. We describe this case of a 44year-old male patient who walked into our emergency department with flank pain and was later discovered to have had renal angiomyolipoma (AML) rupture during his COVID-19 infection, ultimately requiring admission for hemorrhage control via interventional radiology (IR) drainage. Here, we discuss the role of front-line physicians and how they should keep a low threshold for the different presentations that could be associated with COVID-19 infection, such as what was found in this case.