Abstract

The primary objective of this study was to explore whether coronavirus disease 2019 (COVID-19) 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.

Highlights

  • In December 2019, the coronavirus disease 2019 (COVID-19) started to emerge in Wuhan, China, and rapidly spread across the world

  • The primary objective of this study was to explore whether coronavirus disease 2019 (COVID-19) severity and outcomes varied between different ABO blood groups

  • 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

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Summary

Introduction

In December 2019, the coronavirus disease 2019 (COVID-19) started to emerge in Wuhan, China, and rapidly spread across the world. There has been a dramatic rise in the number of COVID-19 infected patients because of its rapid transmission [3]. The number of COVID-19 confirmed patients is 276,436,619, and the mortality rate has reached 5,374,744 deaths [4]. The ABO blood group system is defined by the polymorphism of complex carbohydrate structures of glycoproteins and glycolipids expressed at the extracellular surface of erythrocytes or other cells, such as epithelium, sensory neurons, platelets, and vascular endothelium. Previous observational studies have reported a relationship between ABO blood groups and certain defined pathologies. Another study found an association between ABO blood groups and viral infections such as rotavirus, norovirus (NoV), dengue virus, Norwalk virus, and hepatitis B virus [7]

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