ABO and RhD blood group are not associated with mortality and morbidity in critically ill patients; a multicentre observational study of 29 512 patients

Abstract

Background The ABO and RhD blood group represent antigens on the surface of erythrocytes. The ABO blood group antigens are also present on multiple other cells. Interestingly, previous studies have demonstrated associations between the blood group and many types of disease. The present study aimed to identifying associations between the ABO blood group, the RhD blood group, and morbidity and mortality in a mixed cohort and in six pre-defined subgroups of critically ill patients. Methods Adult patients admitted to any of the five intensive care units (ICUs) in the Scania Region, Sweden, between February 2007 and April 2021 were eligible for inclusion. The outcomes were mortality analysed at 28– and 90–days as well as at the end of observation and morbidity measured using days alive and free of (DAF) invasive ventilation (DAF ventilation) and DAF circulatory support, including vasopressors or inotropes (DAF circulation), maximum Sequential Organ Failure Assessment score (SOFAmax) the first 28 days after admission and length of stay. All outcomes were analysed in separate multivariable regression models adjusted for age and sex. In addition, in a sensitivity analysis, five subgroups of patients with the main diagnoses sepsis, septic shock, acute respiratory distress syndrome, cardiac arrest and trauma were analysed using the same separate multivariable regression models. Results In total, 29,512 unique patients were included in the analyses. There were no significant differences for any of the outcomes between non-O blood groups and blood group O, or between RhD blood groups. In the sensitivity analysis of subgroups, there were no differences in mortality between non-O blood groups and blood group O or between the RhD blood groups. AB was the most common blood group in the COVID-19 cohort. Conclusions The ABO and RhD blood group do not influence mortality or morbidity in a general critically ill patient population.

ABO blood group and link to COVID-19: A comprehensive review of the reported associations and their possible underlying mechanisms

“…Blood type B was related to significantly higher risk of SARS-CoV-2 infection in some studies [ 59 , [68] , [69] , [70] , [71] , [72] , [73] ]; and a meta-analysis indicated that blood type B is associated with higher risk of SARS-CoV-2 infection in Asian, but not in European cohorts [ 74 ]. AB blood type, in turn, has been significantly related to either higher [ 47 , 62 , 68 , [70] , [71] , [72] , [73] , 75 ] or lower [ 59 , 61 ] risk of acquiring COVID-19.…”

COVID-19 enfeksiyonu ile ABO ve Rh kan grubu sistemlerinin ilişkisi

“…Latz et al also found that there was no relationship between the disease severity and blood groups, but the rate of COVID-19 positivity was higher in the B and AB blood groups 31 . In a recent multicenter observational study which involved 29,512 patients, AB blood group was the most frequently detected blood group in the COVID-19 cohort, and no correlation was found between blood types and disease morbidity and mortality 32 . In another newly published review, which comprises the highest number of cases so far, whereas there is little evidence of the relationship between blood types and COVID-19 disease severity; individuals with A blood group have a higher risk of developing the disease compared to O blood group 33 .…”

Blood phenotype O and indirect bilirubin are associated with lower, early COVID-19—related mortality: A retrospective study

“…Groups B, AB, and RhD were not significantly associated with the outcome. Also, the study done by Kanderet al, 20 reported that ABO blood type and RhD status do not appear to influence mortality or morbidity in a general critically ill patient population. These findings should be interpreted with caution considering the high heterogeneity found between the studies when analyzing the risk of infection and the low or very low quality of the evidence.…”