ABO blood group system is associated with COVID-19 mortality: An epidemiological investigation in the Indian population

Abstract

Background: Novel coronavirus disease-19 (COVID-19) has spread worldwide, and to date presence of the virus has been recorded in 215 countries contributing 0.43 million of death. The role of blood groups in susceptibility/resistance to various infectious diseases has been reported. However, the association of blood groups with susceptibility to COVID-19 infections or related death are limited. In the present report, we performed an epidemiological investigation in the Indian population to decipher the importance of blood groups concerning susceptibility or mortality in COVID-19 infection. Materials and Methods: Data on COVID-19 infection and mortality was obtained from the website of the Government of India. Prevalence of ABO blood groups in different states and union territories of India were searched using different databases such as PubMed and Google Scholar. Relevant articles were downloaded, and data were extracted. Spearman’s rank coefficient analysis was employed to study the correlation between blood group frequencies and COVID-19 infection or mortality rate. Results: A significant inverse correlation was observed between the frequency of O blood group and the COVID-19 mortality rate (Spearman r = -0.36, P=0.03), indicating a possible protective role of O blood group against COVID-19 related death. In contrast, the prevalence of blood group B was positively correlated with COVID-19 death/million (Spearman r = 0.67, P<0.0001), suggesting B blood type as a deleterious factor in COVID-19 infection. Conclusions: ABO blood group system is associated with poor prognosis of COVID-19 infection. Blood group O may protects, and subjects with blood type B could be susceptible to COVID-19 mortality. However, further studies on COVID-19 infected patients in different population are required to validate our findings.

Modelling suggests ABO histo-incompatibility may substantially reduce SARS-CoV-2 transmission

“…in countries with high type B frequency such as India, type B individuals should be at higher risk than type A individuals. This prediction has already been substantiated by two studies published during review of this modelling work ( Rahim et al, 2020 ; Padhi et al, 2020 )…”

“…However, there are at least five other testable predictions from this model that may be addressable using existing epidemiological data: in countries with high type B frequency such as India, type B individuals should be at higher risk than type A individuals. This prediction has already been substantiated by two studies published during review of this modelling work ( Rahim et al, 2020 ; Padhi et al, 2020 ) in studies of super-spreading events, the index cases should be disproportionately type O individuals and/or non-secretor individuals. Direct contact-tracing data should in general follow the blood transfusion rules.…”

The Impact of ABO Blood Grouping on COVID-19 Vulnerability and Seriousness: A Retrospective Cross-Sectional Controlled Study among the Arab Community

“…This study's findings contradict the studies carried in Italy and Spain (patients with blood group A+ were at a high risk of respiratory failure while those with blood type O were protected) [15], Spain (group A patients had a high mortality risk, group O patients a low mortality) [16], France (blood group A patients had a high risk of both infection and severe course) [19], Canada (patients with blood groups A and AB showed more severe illness) [21], Turkey (blood group A patients had higher risk, group O patients had lower risk, and ABO does not affect the severity) [23], China (blood group A patients are had high risk of severity and blood group O patients had low) [24], China (blood group A patients had a high risk of infection) [25], USA, and Denmark (no association between ABO, infection, and severity) [26,27], Iraq (blood group A patients are at increased risk of both infection and severity) [28], and India (blood group O patients have decreased mortality; blood group B patients increased mortality) [29].…”

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

“…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.…”