ABO blood type association with SARS‐CoV‐2 infection mortality: A single‐center population in New York City

Abstract

Background Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has a variable clinical course with significant mortality. Early reports suggested higher rates of SARS‐CoV‐2 infection in patients with type A blood and enrichment of type A individuals among COVID‐19 mortalities. Study Design and Methods The study includes all patients hospitalized or with an emergency department (ED) visit who were tested for SARS‐CoV‐2 between March 10, 2020 and June 8, 2020 and had a positive test result by nucleic acid test (NAT) performed on a nasopharyngeal swab specimen. A total of 4968 patients met the study inclusion criteria, with a subsequent 23.1% (n = 1146/4968) all‐cause mortality rate in the study cohort. To estimate overall risk by ABO type and account for the competing risks of in‐hospital mortality and discharge, we calculated the cumulative incidence function (CIF) for each event. Cause‐specific hazard ratios (csHRs) for in‐hospital mortality and discharge were analyzed using multivariable Cox proportional hazards models. Results Type A blood was associated with the increased cause‐specific hazard of death among COVID‐19 patients compared to type O (HR = 1.17, 1.02–1.33, p = .02) and type B (HR = 1.32,1.10–1.58, p = .003). Conclusions Our study shows that ABO histo‐blood group type is associated with the risk of in‐hospital death in COVID‐19 patients, warranting additional inquiry. Elucidating the mechanism behind this association may reveal insights into the susceptibility and/or immunity to SARS‐CoV‐2.

ABO blood group does not influence the level of anti‐SARS‐CoV‐2 antibodies in convalescent plasma donors

“…Already in the early studies of the SARS‐CoV‐2 pandemic, the association of ABO blood group type with the SARS‐CoV‐2 infection has been noticed, where the blood group A was associated with an increased risk of disease compared to the blood group O that was associated with a decreased risk for severe COVID‐19 illness 1,2 . Although certain studies failed to confirm such association, 3,4 several large cohort studies, 5,6 reviews, and meta‐analyses 7–10 confirmed that the individuals with blood group A are more susceptible and those with blood group O are less vulnerable for COVID‐19.…”

HLA and red blood cell antigen genotyping in SARS-CoV-2 convalescent plasma donors

“…The involvement of ABO blood group in COVID-19 has previously been described 9,18 . A significant overrepresentation of AB group and the non-significant but trending underrepresentation of the O group within our cohort appear to be in accordance with other groups’ suggestion that O individuals could be less susceptible to SARS-CoV-2 infection 7,8 , given that every individual in our study was proved to be infected.…”

“…The involvement of ABO blood group in COVID-19 has previously been described[3, 12]. The exact mechanism of action remains elusive, but could be associated to circulating natural anti-A and anti-B antibodies, or a low efficiency furin cleavage in O group individuals[9].…”

Immunothrombotic dysregulation in chagas disease and COVID-19: a comparative study of anticoagulation

“…[ 105 ]. In Brazil, the variants IL17A and IL17F are associated with the development of cardiomyopathy [ 106 ] In the African/African-American population, p.Arg514-Gly, a polymorphism of ACE2, is associated with cardiovascular and pulmonary conditions [ 107 ] In Genome-wide Association Study (GWAS) in Italian and Spanish hospitals, a 3p21.31 gene cluster encompassed the SLC6A20, LZTFL1, CCR9, FYCO1, CXCR6, and XCR1 genes [ 108 ] Genetic polymorphisms of Interferon-γ Production In the Brazilian population, genotypes and alleles of IL12B and IL-10 could be associated with a failure to regulate Th1 responses, IFNγ production, and an increased risk of chronic CD cardiomyopathy [ 109 ] Interferon-gamma gene (IFNG) + 874 T/A polymorphism could be related to a predisposition to CD in the South American population [ 110 ] The single nucleotide polymorphism (SNP) rs6598045 of the interferon-induced transmembrane protein 3 (IFITM3) gene correlates with COVID-19 fatality rates [ 111 ] Populations with a low allele frequency of rs1990760 (T allele) in IFIH1 (InterFeron-Induced Helicase 1; MDA5) are associated with less IFN-beta expression and potential susceptibility to COVID-19 infection [ 112 ] ABO blood group system Inconclusive studies found an increase in blood group B patients dying suddenly from CD [ 113 ] The histo-blood group system explored by GTA, GTB, FUT II, and FUT III glycosyltransferases found that B plus AB secretor phenotypes are related to megaesophagus and megacolon in CD [ 114 ] GWAS found blood group A is associated with COVID-19 and respiratory failure [ 111 ] Type A blood is associated with the risk of in-hospital death [ 115 ] Ethnicity CD with megacolon, calibre and length of the rectosigmoid depends on altitude, ethnicity, and diet [ 116 ] COVID-19 presents an increased risk depending on the population studied, e.g. Black and Asian compared to white subjects had increased risk infection of COVID-19 [ 117 ] In Mexico, native peoples have a higher risk of death due to COVID-19 [ 118 ] Dysregulated immunothrombosis Hypercoagulability The activation of haemostasis is related to the activation and increase of various molecules, e.g.…”