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

Abstract

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.

ABO blood group and rhesus factor association with inpatient COVID-19 mortality and severity: a two-year retrospective review

“…Our study first demonstrates that ABO blood groups alone do not have an influence on COVID-19 mortality ( P =0.405). This is consistent with the observations of several studies [ 5 , 8 , 12 , 17 , 21 ]. However, the results of many studies are inconsistent regarding ABO blood groups and their associations with COVID-19 severity, as some studies suggest a relationship between ABO blood type and mortality, while others do not.…”

Association of blood group with COVID‐19 disease susceptibility and severity in Saudi Arabia

“…These findings are consistent with the study done by Jawdat et al in Saudi Arabia, which concluded that blood group phenotype B is a risk factor for COVID-19 disease, 16 On the contrary; Jiao Zhao et al found that blood group A was associated with an increased risk, whereas blood group O was associated with a decreased risk. 9 A similar study done in India in 2021 revealed that A, B, and RhD positive were found to be more susceptible to COVID-19 infection, whereas blood groups O, AB, and RhD negative were at a lower risk of COVID-19 infection, and no association was found between blood groups and susceptibility to the severity of disease and mortality in this study 25 In Table 4, we summarize other studies from Saudi Arabia that contained a control group (or used historic control data), 20,24,[26][27][28][29][30][31] focusing on blood group association with COVID-19 vulnerability and disease severity. We did not include two studies that lacked a proper control group or detailed statistical analysis.…”

“…In Table 4, we summarize other studies from Saudi Arabia that contained a control group (or used historic control data), 20,24,26–31 focusing on blood group association with COVID‐19 vulnerability and disease severity. We did not include two studies that lacked a proper control group or detailed statistical analysis 32,33 …”

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

“…Other studies also reported no association between ABO blood types and severe COVID-19 outcomes but in accordance with the finds reported for the risk of infection [ 19 , 20 , 60 , 65 , 67 ]. Further studies also failed to report any association between the ABO blood group and severe COVID-19 outcomes [ [79] , [80] , [81] , [82] ].…”