Abstract
BackgroundA case-control study was performed to examine age, gender, and ABO blood groups in 1014 Iraqi hospitalized cases with Coronavirus disease 2019 (COVID-19) and 901 blood donors (control group). The infection was molecularly diagnosed by detecting coronavirus RNA in nasal swabs of patients.ResultsMean age was significantly elevated in cases compared to controls (48.2 ± 13.8 vs. 29.9 ± 9.0 year; probability [p] < 0.001). Receiver operating characteristic analysis demonstrated the predictive significance of age in COVID-19 evolution (Area under curve = 0.858; 95% CI: 0.841 – 0.875; p < 0.001). Males outnumbered females in cases (60.4 vs. 39.6%) and controls (56 vs. 44%). Stratification by age group (< 30, 30 – 39, 40 – 49 and ≥ 50 years) revealed that 48.3% of cases clustered in the age group ≥ 50 years. ABO blood group analysis showed that group A was the most common among cases, while group O was the most common among controls (35.5 and 36.7%, respectively). Blood groups A (35.5 vs. 32.7; corrected p [pc] = 0.021), A+AB (46.3 vs. 41.7%; pc = 0.021) and A+B+AB (68.0 vs. 63.3%; pc = 0.007) showed significantly elevated frequencies in cases compared to controls. Logistic regression analysis estimated odds ratios (ORs) of 1.53 (95% confidence interval [CI]: 1.16 - 2.02), 1.48 (95% CI: 1.14 - 1.93) and 1.50 (95% CI: 1.17 - 1.82) for blood groups A, A+AB and A+B+AB, respectively. Blood group frequencies showed no significant differences between age groups of cases or controls. Regarding gender, male cases were marked with increased frequency of group A (39.9 vs. 28.9%) and decreased frequency of group O (25.9 vs. 41.0%) compared to female cases. Independent re-analysis of ABO blood groups in male and female cases demonstrated that group A was increased in male cases compared to male controls (39.9 vs. 33.1%; OR = 1.65; 95% CI: 1.24 - 2.21; pc = 0.006). On the contrary, no significant differences were found between females of cases and controls.ConclusionsThe study results indicated that blood group A may be associated with an increased risk of developing COVID-19, particularly in males.
Highlights
A case-control study was performed to examine age, gender, and ABO blood groups in 1014 Iraqi hospitalized cases with Coronavirus disease 2019 (COVID-19) and 901 blood donors
Age and gender distributions Mean age was significantly elevated in COVID-19 cases compared to controls (48.2 ± 13.8 vs. 29.9 ± 9.0 year; p < 0.001) (Fig. 1)
A similar observation was made in male (47.8 ± 14.3 vs. 30.5 ± 10.0 year; p < 0.001) and female (48.7 ± 13.1 vs. 29.3 ± 7.5; year; p < 0.001) cases, while there was no significant difference between males and females regarding mean age in patients or controls (Fig. 2)
Summary
A case-control study was performed to examine age, gender, and ABO blood groups in 1014 Iraqi hospitalized cases with Coronavirus disease 2019 (COVID-19) and 901 blood donors (control group). Coronavirus disease 2019 (COVID-19) is a pandemic respiratory infection caused by a novel coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) It has been originated in the city of Wuhan (Central China) and showed a global spread with accelerating rates associated with increasing morbidities and mortalities that seriously impacted public health worldwide [1]. Some biological determinants of the host have been considered as prominent markers associated with susceptibility to COVID-19 Among these determinants, ABO blood groups have recently been introduced as important predisposing factors in the development of infection [7,8,9,10,11,12,13,14,15]
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