Susceptibility of ABO blood group to COVID-19 infections: clinico-hematological, radiological, and complications analysis

Abstract

In the wake of the COVID-19 pandemic, research indicates that the COVID-19 disease susceptibility varies among individuals depending on their ABO blood groups. Researchers globally commenced investigating potential methods to stratify cases according to prognosis depending on several clinical parameters. Since there is evidence of a link between ABO blood groups and disease susceptibility, it could be argued that there is a link between blood groups and disease manifestation and progression. The current study investigates whether clinical manifestation, laboratory, and imaging findings vary among ABO blood groups of hospitalized confirmed COVID-19 patients. This retrospective cohort study was conducted between March 1, 2020 and March 31, 2021 in King Faisal Specialist Hospital and Research Centre Riyadh and Jeddah, Saudi Arabia. Demographic information, clinical information, laboratory findings, and imaging investigations were extracted from the data warehouse for all confirmed COVID-19 patients. A total of 285 admitted patients were included in the study. Of these, 81 (28.4%) were blood group A, 43 (15.1%) were blood group B, 11 (3.9%) were blood group AB, and 150 (52.6%) were blood group O. This was almost consistent with the distribution of blood groups among the Saudi Arabia community. The majority of the study participants (79.6% [n = 227]) were asymptomatic. The upper respiratory tract infection ( P = .014) and shortness of breath showed statistically significant differences between the ABO blood group ( P = .009). Moreover, the incidence of the symptoms was highly observed in blood group O followed by A then B except for pharyngeal exudate observed in blood group A. The one-way ANOVA test indicated that among the studied hematological parameters, glucose ( P = .004), absolute lymphocyte count ( P = .001), and IgA ( P = .036) showed statistically significant differences between the means of the ABO blood group. The differences in both X-ray and computed tomography scan findings were statistically nonsignificant among the ABO age group. Only 86 (30.3%) patients were admitted to an intensive care unit, and the majority of them were blood groups O 28.7% (n = 43) and A 37.0% (n = 30). However, the differences in complications’ outcomes were statistically nonsignificant among the ABO age group. ABO blood groups among hospitalized COVID-19 patients are not associated with clinical, hematological, radiological, and complications abnormality.

Association of blood group with COVID‐19 disease susceptibility and severity in Saudi Arabia

“…These findings are consistent with the study done by Jawdat et al in Saudi Arabia, which concluded that blood group phenotype B is a risk factor for COVID-19 disease, 16 On the contrary; Jiao Zhao et al found that blood group A was associated with an increased risk, whereas blood group O was associated with a decreased risk. 9 A similar study done in India in 2021 revealed that A, B, and RhD positive were found to be more susceptible to COVID-19 infection, whereas blood groups O, AB, and RhD negative were at a lower risk of COVID-19 infection, and no association was found between blood groups and susceptibility to the severity of disease and mortality in this study 25 In Table 4, we summarize other studies from Saudi Arabia that contained a control group (or used historic control data), 20,24,[26][27][28][29][30][31] focusing on blood group association with COVID-19 vulnerability and disease severity. We did not include two studies that lacked a proper control group or detailed statistical analysis.…”

Correlation of SARS-CoV-2 infection severity with ABO blood groups and RhD antigen: a case-control study

“…reported that symptoms were highly observed in blood group O, followed by A and B except for pharyngeal exudate in blood group A. 31 More recently, in a Spanish population-based prospective cohort study, Enguita-German et al. observed no association between ABO blood types and hospitalization, intensive care unit admission, or death in individuals with COVID-19.…”

“…30 In an observational clinico-hematological, radiological, and complication analysis of susceptibility to COVID-19 infection in Saudi Arabia, Kabrah et al reported that symptoms were highly observed in blood group O, followed by A and B except for pharyngeal exudate in blood group A. 31 More recently, in a Spanish population-based prospective cohort study, Enguita-German et al observed no association between ABO blood types and hospitalization, intensive care unit admission, or death in individuals with COVID-19. Regarding the risk of COVID-19 infection, they reported a protective effect in group O and a greater risk in A group.…”

Correlation between ABO blood type, susceptibility to SARS-CoV-2 infection and COVID-19 disease severity: A systematic review

“…( 29 ) Cohort / 8 330 ICU admission and mortality - Increased ICU admission in blood group AB KABRAH et al ., 2021, Saudi Arabia. ( 59 ) Cohort / 7 285 ICU admission and mortality - No significant difference HOILAND et al ., 2020, Canada. ( 44 ) Cross-sectional / 7 95 Mechanical ventilation - Increased need for mechanical ventilation in blood groups A and AB HALIM et al ., 2021, Blangadesh.…”

“…(2021) ( 26 ) Cohort ** * *** KABRAH et al . (2021) ( 59 ) Cohort *** * *** MATZHOLD et al . (2021) ( 27 ) Cohort *** * ** MULLINS et al .…”