Association of ABO blood group with in‐hospital adverse outcome and long term persistent symptoms of COVID‐19 infection: A single‐center longitudinal observational study

Abstract

Background and Aims: There are gaps in knowledge regarding the association between the ABO blood group and coronavirus disease 2019 (COVID-19) immediate and long-term outcomes. We aimed to investigate the association of ABO blood group with COVID-19 in-hospital adverse outcomes and to determine whether ABO blood group is associated with post-COVID-19 persistent symptoms.Methods: This was a single-center longitudinal observational study that included patients who presented with symptoms suggestive of COVID-19 infection and a positive test for COVID-19 and were able to attend the out-patient clinic after 6 months following acute COVID-19. The main outcomes were intensive care unit admission, the requirement for respiratory support, in-hospital death, and persistent symptoms. χ 2 test and regression analysis were used to analyze the collected data.Results: A total of 169 patients were enrolled for the assessment of in-hospital adverse outcomes of whom 86 patients were included for the assessment of persistent symptoms after the exclusion of deceased patients or patients not attended the out-patient clinic. Patients with blood group B had higher prevalence of in-hospital death compared to blood group O (39% vs. 13%, p = 0.01) and this persisted after adjusting for sex (odds ratio, OR [confidence interval, CI] = 1.4 [1.1-2.1], p = 0.04), while patients with blood group AB had higher prevalence of requiring respiratory support than blood group O (54% vs. 10%, p = 0.02) and this persisted after adjusting for age (OR [CI] = 1.5 [1.1-2.3], p = 0.02). Concerning the association of ABO blood group and long-term symptoms, blood group AB showed a higher prevalence of palpitation (p < 0.001) and dizziness (p = 0.02) than other blood groups.Conclusions: Blood groups AB and B are significantly associated with respiratory support use and in-hospital death, respectively, compared to blood group O. Blood group AB is significantly associated with persistent palpitation and dizziness compared to other blood groups.

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

“…Conversely, El-Shitany et al reported an association between blood type O and unfavorable outcomes, such as lower oxygen saturation and mechanical ventilation requirement, while blood type A was linked to lower odds of requiring artificial ventilation, and blood type B, to shorter recovery periods [ 51 ]. Significant associations with severity [ 84 ] and mortality [ 69 , 89 ] were also reported for blood type B, while blood type AB has been linked to either favorable [ 84 ], or unfavorable [ 89 ] outcomes. More recently, some studies sought to investigate whether ABO blood types are associated with long-term symptoms presentation after COVID-19 recovery.…”

“…More recently, some studies sought to investigate whether ABO blood types are associated with long-term symptoms presentation after COVID-19 recovery. Blood type AB was significantly associated with long-term palpitation and dizziness [ 89 ], and blood type O, with subjective loss of smell [ 90 ].…”

Association of ABO blood types and clinical variables with COVID-19 infection severity in Libya

“…44 According to a similar study done in Iraq, the blood type AB is substantially more likely than other blood types to require respiratory support, experience persistent palpitations, and dizziness. 45 The risk of intubation and/or mortality was found to be high with the “AB” blood group and low with the “A” blood group by Zietz et al when they investigated the relationship between the severity of COVID-19 and the ABO blood group system. 41 While Ad’hiah et al termed the “AB” blood type as a possible biomarker for COVID-19 susceptibility.…”

ABO Blood Groups and Incidence of COVID-19 in the Mass Gathering Events in Borriana (Spain), March 2020: A Retrospective Cohort Study

“…Discordant results have been published on the association between sequelae and complications post-COVID-19 and ABO, with the B-group [ 21 ], O-group [ 22 ], or AB-group [ 23 ] associated with more risk of complications.…”