Abstract
The ABO blood group system has been linked with multiple infectious and non-infectious diseases and disorders such as, hepatitis B, dengue haemorrhagic fever, cancer, cardiovascular diseases, hematologic disorders, metabolic diseases, malaria, etc. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is the virus that causes COVID-19 (Coronavirus disease 2019), a respiratory infectious disease that has become a global pandemic. Several reports have investigated the role of ABO blood groups in susceptibility/resistance to various infectious Diseases, and have proposed that ABO blood group polymorphism may be linked with COVID-19 susceptibility and clinical outcomes, however, the results were questionable. It has been suggested that blood type O may have a protective role against COVID-19 infection, as blood group O individuals were found COVID-19 positive in lower levels. This could emonstrate that those Individuals are less susceptible to infection, or are asymptomatic in higher proportions, or may be associated with a slightly lower risk for severe COVID-19 disease. It has been hypothesized that the mentioned association can be probably explained by the configuration of distribution of the sialic acid-containing receptors on host cell surfaces induced by ABO antigens through carbohydrate-carbohydrate interactions, that could maximize or minimize the SARS-CoV-2 virus spike protein (S) binding to the host cell. The classical viral entry through the ACE-2 receptors can be prevented by the anti-A antibodies that are produced from O and B blood group individuals. Experimental models based on cellular lines suggested a possible explanation for blood type configuration of infection showing that S protein/ACE-2-dependent adhesion to ACE 2-expressing cells was especially inhibited by natural or monoclonal human anti-A antibodies. Consequently, non-A blood groups individuals, mainly O, or B blood group, that produce anti-A antibodies, may have a lesser degree of susceptible to SARS-CoV-2 infection due to the inhibitory effects of anti-A antibodies. Therefore, it is possible that individuals with group A are more susceptible to SARS-CoV-2 infection and/or manifestation of a severe status.
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