Association Between ABO and Rh Blood Groups and SARS-CoV-2 Infection or Severe COVID-19 Illness

Ray, Joel G.; Schull, Michael J.; Vermeulen, Marian J.; Park, Alison L.

doi:10.7326/m20-4511

Cited by 178 publications

(231 citation statements)

References 33 publications

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“…The present study findings are in line with the studies carried in France (patients with blood type O required more O2 and ICU) [17,18], Canada (patients with blood type O were less infected with a severe illness) [20], Turkey (patients with blood type O were less infected and those with blood type A less associated with mortality) [22], Spain [16], China [24], Denmark [27], Sudan [30], and Iran [31] and the metanalysis carried out by [32] (patients with blood type O were less infected).…”

Section: Discussionsupporting

confidence: 92%

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

El-Shitany

El‐Hamamsy

Alahmadi

et al. 2021

IJERPH

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Background and Objectives: Studies have noted that some ABO blood types are more susceptible to COVID-19 virus infection. This study aimed to further confirm the relationship between different blood groups on the vulnerability, symptoms, cure period, and severity among COVID-19 recovered patients. Subjects and Methods: This cross-sectional study approached the participants from the Arab community via social media (mainly Facebook and WhatsApp). The data were collected through two Google Form questionnaires, one for COVID-19 recovered patients (COVID-19 group, n = 726), and the other for the healthy people (Control group, n = 707). Results: The subjects with blood group O were the least likely to be infected with the COVID-19 virus, while those with blood group A were not likely to be the most susceptible. There were significant differences among different ABO blood groups regarding the distribution of oxygen saturation percentage, myalgia, and recovery time after COVID-19 infection (p < 0.01, 0.01, and 0.05, respectively). The blood group A showed the highest percentage of patients who experienced an oxygen saturation range of 90–100%, whereas the blood group O showed the highest percentage of patients who experienced an oxygen saturation range of 70–80%. The blood group A showed the lowest percentage of patients who required artificial respiration, whereas the blood group O showed the highest percentage of patients who required artificial respiration. The blood group B showed the lowest percentage of patients who experienced myalgia and exhibited the lowest percentage of patients who needed 3 weeks or more to recover. Conclusion: The people of blood group O may be the least likely to be infected with COVID-19, however, they may be the more in need of treatment in hospital and artificial respiration compared to the other blood groups.

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Section: Discussionsupporting

confidence: 92%

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

El-Shitany

El‐Hamamsy

Alahmadi

et al. 2021

IJERPH

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“…Increased risk of intubation and death has been inconsistently found among patients with blood types AB, A, and B relative to type O. 17–19 In contrast, we found that blood type AB was protective.…”

Section: Discussioncontrasting

confidence: 67%

The National COVID Cohort Collaborative: Clinical Characterization and Early Severity Prediction

Bennett

Moffitt

Hajagos

et al. 2021

Preprint

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BackgroundThe majority of U.S. reports of COVID-19 clinical characteristics, disease course, and treatments are from single health systems or focused on one domain. Here we report the creation of the National COVID Cohort Collaborative (N3C), a centralized, harmonized, high-granularity electronic health record repository that is the largest, most representative U.S. cohort of COVID-19 cases and controls to date. This multi-center dataset supports robust evidence-based development of predictive and diagnostic tools and informs critical care and policy.Methods and FindingsIn a retrospective cohort study of 1,926,526 patients from 34 medical centers nationwide, we stratified patients using a World Health Organization COVID-19 severity scale and demographics; we then evaluated differences between groups over time using multivariable logistic regression. We established vital signs and laboratory values among COVID-19 patients with different severities, providing the foundation for predictive analytics. The cohort included 174,568 adults with severe acute respiratory syndrome associated with SARS-CoV-2 (PCR >99% or antigen <1%) as well as 1,133,848 adult patients that served as lab-negative controls. Among 32,472 hospitalized patients, mortality was 11.6% overall and decreased from 16.4% in March/April 2020 to 8.6% in September/October 2020 (p = 0.002 monthly trend). In a multivariable logistic regression model, age, male sex, liver disease, dementia, African-American and Asian race, and obesity were independently associated with higher clinical severity. To demonstrate the utility of the N3C cohort for analytics, we used machine learning (ML) to predict clinical severity and risk factors over time. Using 64 inputs available on the first hospital day, we predicted a severe clinical course (death, discharge to hospice, invasive ventilation, or extracorporeal membrane oxygenation) using random forest and XGBoost models (AUROC 0.86 and 0.87 respectively) that were stable over time. The most powerful predictors in these models are patient age and widely available vital sign and laboratory values. The established expected trajectories for many vital signs and laboratory values among patients with different clinical severities validates observations from smaller studies, and provides comprehensive insight into COVID-19 characterization in U.S. patients.ConclusionsThis is the first description of an ongoing longitudinal observational study of patients seen in diverse clinical settings and geographical regions and is the largest COVID-19 cohort in the United States. Such data are the foundation for ML models that can be the basis for generalizable clinical decision support tools. The N3C Data Enclave is unique in providing transparent, reproducible, easily shared, versioned, and fully auditable data and analytic provenance for national-scale patient-level EHR data. The N3C is built for intensive ML analyses by academic, industry, and citizen scientists internationally. Many observational correlations can inform trial designs and care guidelines for this new disease.

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“…Likewise, a very careful clinical analysis of critically ill Canadian patients revealed that blood groups A and AB patients presented a higher risk of requiring mechanical ventilation, continuous renal replacement therapy, and prolonged admission to intensive care units than blood groups O and B patients [ 29 ]. In another study from Canada, the O blood group was also found associated with lower severity, whereas the B and AB blood groups were associated with higher severity [ 15 ]. In that study involving a large series of patients, the frequencies of ABO blood types were compared between cases with severe illness or death and all other cases, severe illness being defined as requirement for admission to intensive care unit.…”

Section: Studies Linking Abo Blood Types To Covid-19mentioning

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%

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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Association Between ABO and Rh Blood Groups and SARS-CoV-2 Infection or Severe COVID-19 Illness

Cited by 178 publications

References 33 publications

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

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

The National COVID Cohort Collaborative: Clinical Characterization and Early Severity Prediction

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

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