Association of ABO blood group with COVID-19 severity, acute phase reactants and mortality

Ishaq, Uzma; Malik, Asmara; Malik, Jahanzeb; Mehmood, Asad; Qureshi, Azhar Munir; Laique, Talha; Zaidi, Syed Muhammad Jawad; Javaid, Muhammad; Rana, Abdul Sattar

doi:10.1371/journal.pone.0261432

Cited by 16 publications

(17 citation statements)

References 15 publications

(19 reference statements)

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“…did not demonstrate any significant association of ABO groups with infection severity, associated death, or acute phase reactants in a retrospective cohort study of 1067 patients with COVID-19. 27 Moreover, in a multi-institutional study of 1289 patients with COVID-19, Latz et al. did not find any association between blood types and the risk of severe COVID-19 progression, intubation, or death or inflammatory marker elevation.…”

Section: Discussionmentioning

confidence: 96%

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

et al. 2022

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Objective The role of ABO types and RhD antigen in coronavirus disease 2019 (COVID-19) severity has been investigated in several recent studies. Thus, the objective of this study was to identify the relationship of ABO and RhD types with symptomatic COVID-19 disease and determine the groups associated with an increased risk of hospitalization. Methods This observational case-control study was performed in 530 Iraqi-Kurdish patients with COVID-19. Among them, 184 were severe cases that required hospitalization, while 346 were mild to moderate cases that were treated at home. ABO and RhD antigen groups were compared between cases and 1698 control records from 1 year before the pandemic. The diagnosis of COVID-19 was based on real-time polymerase chain reaction tests and high-resolution chest computed tomography scans with the typical clinical presentation. Results There were no significant differences in ABO and RhD antigen distributions between the COVID-19 cases and non-COVID controls. No ABO group was associated with the risk of hospitalization as a marker of the severity of infection. Conclusions There was no significant association between symptomatic COVID-19 disease and any ABO group or RhD antigen type. No impact of ABO groups on hospitalization was documented.

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Section: Discussionmentioning

confidence: 96%

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

et al. 2022

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“…Furthermore, emerging studies have shown that ABO blood groups may also play a major role in the course of illness and in the outcome of COVID-19 patients; for example, COVID-19 was found to be less prevalent among people with blood group O. On the other hand, people with blood group A were more susceptible to acquiring COVID-19 with a higher mortality rate [ 9 - 11 ].…”

Section: Introductionmentioning

confidence: 99%

Variation in COVID-19 Disease Severity and Clinical Outcomes Between Different ABO Blood Groups

Bokhary¹,

Bokhary²,

Seadawi³

et al. 2022

Cureus

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The primary objective of this study was to explore whether coronavirus disease 2019 severity and outcomes varied between different ABO blood groups. This retrospective study included 363 COVID-19 confirmed patients who had their blood group recorded in the hospital medical records, from March to June 2020. Data representing demographics, clinical features, vital signs, laboratory findings, and COVID-19 outcomes were collected. Multivariate logistic regression was used for analysis and the results were adjusted for sociodemographic, clinical, and laboratory variables. The patients' mean age was 50 ± 17.8 years. Of the 363 patients, 30% were blood group A, 22.3% were blood group B, 8.8% were blood group AB, and 38.8% were blood group O. Bivariate analysis showed that patients with blood group AB were more likely to be free of any medical disease (65.6%) compared to other blood groups (p = 0.007). Fever was the most common presenting complaint (66.7%), and it did not significantly vary with changes in ABO blood groups (p = 0.230). Regarding laboratory characteristics, only C-reactive protein (CRP) levels were significantly associated with the blood groups, with high levels seen in blood groups A, B, and O (p = 0.036). In multivariate analysis, variations in emergency department (ED) disposition, requirement of intensive care unit care, and requirement of mechanical ventilation were not statistically significant among the different ABO blood groups. Furthermore, no correlation was found between hospital death and the different ABO blood groups. In conclusion, COVID-19 is most prevalent among patients with blood group O and least prevalent among those with blood group AB. No particular blood group had worse COVID-19 disease severity and outcomes than other blood groups. Therefore, we believe that ABO blood grouping should not be used as a major assessment tool for COVID-19 disease severity and outcome, and other known risk factors should be investigated.

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“…Some contrasting literature data were reported on the specific subjects' different susceptibility to the viral attack, based on determined genetic mutations, blood groups/diseases, specific receptors expression. 73,193,311,[353][354][355][356][357][358][359][360] Beyond a specific possible TMPRSS2-related predisposition on a genetic or epigenetic (e.g. diabetic and obese patients) basis, 361 the majority of these speculations refer both to the variability of the membrane expression of certain receptors (namely SA and CD147), and to the consequent cation dysmetabolism.…”

Section: Discussionmentioning

confidence: 99%

COVID-19, Cation Dysmetabolism, Sialic Acid, CD147, ACE2, Viroporins, Hepcidin and Ferroptosis: A Possible Unifying Hypothesis

Cavezzi

Menicagli

Troiani³

et al. 2022

F1000Res

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Background: iron and calcium dysmetabolism, with hyperferritinemia, hypoferremia, hypocalcemia and anemia have been documented in the majority of COVID-19 patients at later/worse stages. Furthermore, complementary to ACE2, both sialic acid (SA) molecules and CD147 proved relevant host receptors for SARS-CoV-2 entry, which explains the viral attack to multiple types of cells, including erythrocytes, endothelium and neural tissue. Several authors advocated that cell ferroptosis may be the core and final cell degenerative mechanism. Methods: a literature research was performed in several scientific search engines, such as PubMed Central, Cochrane Library, Chemical Abstract Service. More than 500 articles were retrieved until mid-December 2021, to highlight the available evidence about the investigated issues. Results: based on COVID-19 literature data, we have highlighted a few pathophysiological mechanisms, associated with virus-based cation dysmetabolism, multi-organ attack, mitochondria degeneration and ferroptosis. Our suggested elucidated pathological sequence is: a) spike protein subunit S1 docking with sialylated membrane glycoproteins/receptors (ACE2, CD147), and S2 subunit fusion with the lipid layer; b) cell membrane morpho-functional changes due to the consequent electro-chemical variations and viroporin action, which induce an altered ion channel function and intracellular cation accumulation; c) additional intracellular iron concentration due to a deregulated hepcidin-ferroportin axis, with higher hepcidin levels. Viral invasion may also affect erythrocytes/erythroid precursors, endothelial cells and macrophages, through SA and CD147 receptors, with relative hemoglobin and iron/calcium dysmetabolism. AB0 blood group, hemochromatosis, or environmental elements may represent possible factors which affect individual susceptibility to COVID-19. Conclusions: our literature analysis confirms the combined role of SA molecules, ACE2, CD147, viroporins and hepcidin in determining the cation dysmetabolism and final ferroptosis in the cells infected by SARS-CoV-2. The altered ion channels and electrochemical gradients of the cell membrane have a pivotal role in the virus entry and cell dysmetabolism, with subsequent multi-organ immune-inflammatory degeneration and erythrocyte/hemoglobin alterations.

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Association of ABO blood group with COVID-19 severity, acute phase reactants and mortality

Cited by 16 publications

References 15 publications

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

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

Variation in COVID-19 Disease Severity and Clinical Outcomes Between Different ABO Blood Groups

COVID-19, Cation Dysmetabolism, Sialic Acid, CD147, ACE2, Viroporins, Hepcidin and Ferroptosis: A Possible Unifying Hypothesis

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