Abstract
BackgroundDisease severity among patients infected with SARS-CoV-2 varies remarkably. Preliminary studies reported that the ABO blood group system confers differential viral susceptibility and disease severity caused by SARS-CoV-2. Thus, differences in ABO blood group phenotypes may partly explain the observed heterogeneity in COVID-19 severity patterns, and could help identify individuals at increased risk. Herein, we explored the association between ABO blood group phenotypes and COVID-19 susceptibility and severity in a Saudi Arabian cohort.MethodsIn this retrospective cohort study, we performed ABO typing on a total of 373 Saudi patients infected with SARS-CoV-2 and conducted association analysis between ABO blood group phenotype and COVID-19 infection severity. We then performed gender-stratified analysis by dividing the participating patients into two groups by gender, and classified them according to age.ResultsThe frequencies of blood group phenotypes A, B, AB and O were 27.3, 23.6, 5.4 and 43.7%, respectively. We found that blood group phenotype O was associated with a lower risk of testing positive for COVID-19 infection (OR 0.76 95% CI 0.62–0.95, p = 0.0113), while blood group phenotype B was associated with higher odds of testing positive (OR 1.51 95% CI 1.17–1.93, p = 0.0009). However, blood group phenotype B was associated with increased risk in the mild and moderate group but not the severe COVID-19 infection group. Blood group phenotype O was protective in all severity groups.ConclusionOur findings provide evidence that blood group phenotype B is a risk for COVID-19 disease while blood group phenotype O is protective from COVID-19 infection. However, further studies are necessary to validate these associations in a larger sample size and among individuals of different ethnic groups.
Highlights
The rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the resulting coronavirus disease 2019 (COVID-19) has caused drastic morbidity and mortality, igniting an unprecedented effort from scientists and clinicians to rapidly unravel the pathogenesis of disease [1]
We found that blood group phenotype O was associated with a lower risk of testing positive for COVID-19 infection, while blood group phenotype B was associated with higher odds of testing positive
Previous work has demonstrated that ABO allele frequencies and distributions of the ABO gene can be appropriate indices for investigating vulnerability to certain infections or disease severity following infections, including SARS-CoV-1 [6]
Summary
The rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the resulting coronavirus disease 2019 (COVID-19) has caused drastic morbidity and mortality, igniting an unprecedented effort from scientists and clinicians to rapidly unravel the pathogenesis of disease [1]. There is remarkable variability in viral susceptibility and disease severity caused by SARSCoV-2 infection, while certain individuals exhibit almost no symptoms, others experience acute respiratory distress syndrome, septic shock, and even death [4, 5]. The ABO blood group system, which is widely used in clinical practice, has been shown in previous studies to confer differential viral susceptibility and disease severity caused by viruses, including SARS-CoV-1 [6]. As with SARS-CoV-1, preliminary evidence suggests a potential correlation between blood group antigens and increased susceptibility to or amplified severity of COVID-19 disease [8,9,10,11]. Differences in ABO blood group antigen expression may help explain discrepancies of COVID-19 spread, severity and mortality. We further classified the cohort according to gender and age
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