Infection and thrombosis associated with COVID-19: Possible role of the ABO blood group

Marcos, Saioa Zalba; Antelo, María Luisa; Galbete, Arkaitz; Etayo, Maialen; Ongay, Eva; García-Erce, José Antonio

doi:10.1016/j.medcle.2020.06.013

Cited by 24 publications

(25 citation statements)

References 11 publications

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“…( A ) Blood group O odd ratios (ORs) of COVID-19 relative to the other blood groups and blood group O frequencies at various geographical locations. Odd ratios were obtained from the works in [ 1 , 2 , 3 , 6 , 9 , 10 , 11 , 14 , 17 , 18 , 19 , 22 , 24 ], and the frequencies of blood group O were those reported in the groups of controls of the corresponding studies, representing frequencies in the local populations. OR values in populations where frequencies of blood group O are below and above 40% (O < 0.4 and O > 0.4, respectively) were compared by a two-tailed Mann–Whitney test.…”

Section: Figurementioning

confidence: 99%

“…Thus, soon after the beginning of the pandemic a publication from Wuhan, China, reported a higher risk of infection for people of blood group A, and inversely a lower risk for people of blood group O [ 1 ]. Since then, associations with the ABO blood groups have been described in several additional publications from China as well as many other locations from Asia, the Middle East, Europe, and North America [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. Associations between ABO phenotypes were described with either the risk of infection or disease severity, although most studies did not explicitly separate these two aspects.…”

Section: Introductionmentioning

confidence: 99%

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ABO Blood Types and COVID-19: Spurious, Anecdotal, or Truly Important Relationships? A Reasoned Review of Available Data

Pendu

Breiman

Rocher

et al. 2021

Viruses

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Since the emergence of COVID-19, many publications have reported associations with ABO blood types. Despite between-study discrepancies, an overall consensus has emerged whereby blood group O appears associated with a lower risk of COVID-19, while non-O blood types appear detrimental. Two major hypotheses may explain these findings: First, natural anti-A and anti-B antibodies could be partially protective against SARS-CoV-2 virions carrying blood group antigens originating from non-O individuals. Second, O individuals are less prone to thrombosis and vascular dysfunction than non-O individuals and therefore could be at a lesser risk in case of severe lung dysfunction. Here, we review the literature on the topic in light of these hypotheses. We find that between-study variation may be explained by differences in study settings and that both mechanisms are likely at play. Moreover, as frequencies of ABO phenotypes are highly variable between populations or geographical areas, the ABO coefficient of variation, rather than the frequency of each individual phenotype is expected to determine impact of the ABO system on virus transmission. Accordingly, the ABO coefficient of variation correlates with COVID-19 prevalence. Overall, despite modest apparent risk differences between ABO subtypes, the ABO blood group system might play a major role in the COVID-19 pandemic when considered at the population level.

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Section: Figurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

ABO Blood Types and COVID-19: Spurious, Anecdotal, or Truly Important Relationships? A Reasoned Review of Available Data

Pendu

Breiman

Rocher

et al. 2021

Viruses

View full text Add to dashboard Cite

show abstract

“…Countries with higher A phenotype and Rh negative blood group showed higher values of the prevalence and mortality rate [5]. However, studies on the association between COVID-19 and ABO phenotypes are at preliminary stage and the results are controversial [15][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

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confidence: 99%

Susceptibility to the novel coronavirus disease (COVID-19) is associated with ABO and Rh blood groups: a case-control study from Afghanistan

Saify¹,

Alborz²,

Saadat

2021

Egypt J Med Hum Genet

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Background There are preliminary studies about the association between COVID-19 and ABO phenotypes and the results are controversial. There are only two studies which investigated the association of Rh blood groups in addition to ABO with COVID-19; however, in the statistical analysis ABO and Rh blood groups have been considered separately. Therefore, the present case-control study was performed to determine the association of COVID-19 with ABO blood groups considering the Rh blood groups simultaneously. The study was conducted in Kunduz COVID-19 treatment specific center, Spin-Zar Hospital (Kunduz Province, North East Afghanistan). A total of 301 confirmed COVID-19 cases and 1039 healthy blood donors as control group were included in the study. Results The Rh− phenotype strongly increased the risk of COVID-19 (OR = 2.97, 95% CI 1.86–3.89, P < 0.001). Although blood group A increased the risk of developing COVID-19, the association did not reach statistical significance. In analysis of the combination phenotypes, the A− blood group remarkably increased the risk of COVID-19 (OR = 7.24, 95% CI 3.62–14.4, P < 0.001). Multivariate analysis revealed that the interaction of Rh and ABO is significant (P < 0.013). Conclusion These findings indicate that susceptibility to COVID-19 is strongly associated with A− blood group.

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“…Marcos et al studied 226 patients and found lower incidence of COVID-19 and thrombosis in blood group O when compared to general population [ 29 ]. We did not observe lower rates of venous thrombosis or embolism in blood group O.…”

Section: Discussionmentioning

confidence: 99%

Does ABO Blood Groups Affect Outcomes in Hospitalized COVID-19 Patients?

Kumar¹,

Nanchal²,

Hererra³

et al. 2021

J Hematol

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Background Blood group type A has been associated with increased susceptibility for coronavirus disease 2019 (COVID-19) infection when compared to group O. The aim of our study was to examine outcomes in hospitalized COVID-19 patients among blood groups A and O. Methods This is an observational study. Kruskal-Wallis and Chi-square tests were used to compare continuous and categorical variables. Multivariable logistic regression models were used to examine association of blood groups with rates of mortality and severity of disease. All adult patients (> 18 years) admitted with COVID-19 infection between March 1, 2020 and March 10, 2021 at a large community hospital in Northeast Georgia were included. We compared mortality, severity of disease (use of mechanical ventilation, vasopressor, and acute renal failure), rates of venous thromboembolism and inflammatory markers between the blood groups. We used multivariable logistic regression model to adjust for demographical and clinical characteristics, use of COVID-19 medications and severity. Results A total of 3,563 of 5,204 admitted patients had information on blood groups. Of these, 1,301 (36.5%) were group A, 377 (10.6 %) were group B, 133 (3.7%) were group AB and 1,752 (49.2%) were group O. On adjusted analysis, there were no significant differences in rates of intensive care unit (ICU) admissions, mechanical ventilation, vasopressors, acute renal failure, venous thromboembolism and readmission rate between the blood groups A and O. In-hospital mortality was also not statistically different among the blood groups A and O (17.5% vs. 20.1%; P = 0.07). On adjusted analysis, in-hospital mortality was not lower in blood groups O (odds ratio (OR): 1.06; 95% confidence interval (CI): 0.80 - 1.40, P = 0.70). Conclusions Once hospitalized with COVID-19 infection, blood groups A and O are not associated with increased severity or in-hospital mortality.

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Infection and thrombosis associated with COVID-19: Possible role of the ABO blood group

Cited by 24 publications

References 11 publications

ABO Blood Types and COVID-19: Spurious, Anecdotal, or Truly Important Relationships? A Reasoned Review of Available Data

ABO Blood Types and COVID-19: Spurious, Anecdotal, or Truly Important Relationships? A Reasoned Review of Available Data

Susceptibility to the novel coronavirus disease (COVID-19) is associated with ABO and Rh blood groups: a case-control study from Afghanistan

Does ABO Blood Groups Affect Outcomes in Hospitalized COVID-19 Patients?

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