Systematic review and meta-analysis of the effect of ABO blood group on the risk of SARS-CoV-2 infection
PloS one. 2022;17(7):e0271451
We have been experiencing a global pandemic with baleful consequences for mankind, since the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was first identified in Wuhan of China, in December 2019. So far, several potential risk factors for SARS-CoV-2 infection have been identified. Among them, the role of ABO blood group polymorphisms has been studied with results that are still unclear. The aim of this study was to collect and meta-analyze available studies on the relationship between SARS-CoV-2 infection and different blood groups, as well as Rhesus state. We performed a systematic search on PubMed/MEDLINE and Scopus databases for published articles and preprints. Twenty-two studies, after the removal of duplicates, met the inclusion criteria for meta-analysis with ten of them also including information on Rhesus factor. The odds ratios (OR) and 95% confidence intervals (CI) were calculated for the extracted data. Random-effects models were used to obtain the overall pooled ORs. Publication bias and sensitivity analysis were also performed. Our results indicate that blood groups A, B and AB have a higher risk for COVID-19 infection compared to blood group O, which appears to have a protective effect: (i) A group vs O (OR = 1.29, 95% Confidence Interval: 1.15 to 1.44), (ii) B vs O (OR = 1.15, 95% CI 1.06 to 1.25), and (iii) AB vs. O (OR = 1.32, 95% CI 1.10 to 1.57). An association between Rhesus state and COVID-19 infection could not be established (Rh+ vs Rh- OR = 0.97, 95% CI 0.83 to 1.13).
The Role of ABO Blood Type in Patients with SARS-CoV-2 Infection: A Systematic Review
Journal of clinical medicine. 2022;11(11)
The SARS-CoV-2 infection has caused over 422 million contagions and 5.8 million deaths resulting in a global health crisis. Several studies have investigated the risk factors predisposing to the infection and reported that the host susceptibility can be linked to the ABO blood group, but the current evidence is controversial. We systematically searched for articles in EMBASE, PubMed, and Cochrane library published up to 7 May 2021 to explore the association of the ABO blood group with the susceptibility to SARS-CoV-2 infection. All studies in people undergoing SARS-CoV-2 test controls were included. Odds ratios were obtained in each study and then synthesised by using meta-analysis. Overall, 22 articles were selected and more than 1,200,000 individuals of whom 74,563 resulted positive to SARS-CoV-2 and 1,166,717 resulted negative, were included in the meta-analysis. Overall, 487,985 subjects had blood group A, 151,879 had group B, 52,621 had group AB, and 548,795 had group O. Group O was slightly less associated with infection, as compared to the other three blood groups (OR = 0.91, 95% CI = 0.85-0.99, p = 0.02). Conversely, group A was slightly more associated with infection, as compared to the other three groups (OR = 1.06, 95% CI = 1.00-1.13, p = 0.04). This meta-analysis shows associations between blood groups and SARS-CoV-2 infection and supports the hypothesis that blood type O may have a slightly lower risk of infection, whereas blood type A may have a slightly higher risk of infection.
Covid-19 Clinical Course and Blood Groups: Turkish Population-Based Study
Turkish journal of medical sciences. 2021
BACKGROUND/AIM: SARS-CoV-2 enters the cell through the binding of the S glycoprotein on the surface of the virus to the angiotensin-converting enzyme 2 (ACE-2) in the host cells and also SARS-CoV S protein binding to ACE-2 was inhibited by anti-A antibodies. The aim of the study was to investigate the relationship between blood groups and the course of COVID-19 in Turkey. MATERIALS AND METHODS Laboratory confirmed COVID-19 patients aged 18 and over (n=39.850) were randomized in age and gender-matched groups according to blood groups Results: Advanced age, male gender and blood group A were found to be related with increased rate of intensive care unit (ICU) admission (OR =1.089, 95% CI: 1.085-1.093 for age; OR=1.963, 95% CI: 1.737-2.218 for male gender; OR=1.216, 95% CI: 1.023-1.446 for blood group A). When blood group O individuals were compared to non-O individuals, no significant difference was observed regarding the rate of hospital and ICU admission, mechanical ventilation (MV) support, length of hospital and ICU stay, and case fatality rate (CFR). The CFR in patients with blood group A, B, O, and AB were 2.6%, 2.2%, 3.1%, and 2.3%, respectively. There were no significant differences between Rh-negative and positive patients regarding the rate of hospital and ICU admission (p=0.280 and p=0.741, respectively), also the rate of MV support and CFR was similar (p=0.933 and p= 0.417). CONCLUSION Our study revealed that ABO and Rh blood groups do not have any impact on the rate of hospital admission, hospital and ICU stay, MV support, and CFR.
Association between COVID-19 Infection and ABO Blood Types in Mazandaran Province, Iran: A Cross-Sectional Study
Journal of Mazandaran University of Medical Sciences. 2021;31(197):35-43
Background and purpose: The association between ABO blood types and Coronavirus disease 2019 (COVID-19) have been investigated in several studies but there are inconsistencies in results The purpose of this study was to investigate the association between ABO blood types and COVID-19 infection based on serologic results Materials and methods: A cross-sectional seroepidemiologic study was carried out in 1504 people living in Mazandaran province, north of Iran Blood samples were drawn to determine blood groups Also, IgG and IgM antibodies were measured by ELISA Data analysis was done using Chisquare, Fisher’s exact test, univariate and multivariate logistic regression analyses in SPSS V25 Results: The frequency of IgG positive among blood groups A, B, AB, and O was 12 7%, 11 8%, 9 4%, and 9 6%, respectively After adjusting for suspicious confounding factors, the odds ratio of COVID-19 infection was 1 19 (95% CI:0 85-1 67) in blood group A, 1 33 (95% CI:0 94-1 87) in blood group B, 0 82 (95% CI:0 44-1 55) in blood group AB, and 0 70 (CI 95%:0 50-0 98) in blood group O based on serologic results (IgG+/IgM+) Conclusion: The odds ratio for COVID-19 was significantly lower (30%) in blood group O compared to other blood groups, so blood group O can be considered as a protective factor against COVID-19 [ABSTRACT FROM AUTHOR] Copyright of Journal of Mazandaran University of Medical Sciences (JMUMS) is the property of Mazandaran University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )
Systematic Review and Meta-analysis of the Susceptibility of ABO Blood Group to COVID-19 Infection
Transfusion and Apheresis Science. 2021;:103169-103169
Background Numerous studies investigate the association between the ABO blood groups and the occurrence of COVID-19 infection;discordant findings were reported Therefore, the purpose of this meta-analysis was to evaluate the existing evidence on the susceptibility of the ABO blood group to COVID-19 infection Methods Systematically searched published articles in PubMed, Google Scholar, Scopus, and EMBASE between 1 st January 2020 and 21 st March 2021 After quality control and the exclusion of irrelevant studies, 12 studies were included in the final analysis Results Although the random-effect meta-analysis revealed a large heterogeneity among studies, I 2 = 99 197% The pooled event rates and (95% CIs) for A, O, B, and AB blood group were 0 459 (95%CI: 0 358–0 441), 0 342 (95%CI: 0 298–0 374), 0 180 (95%CI: 0 150–0 214), and 0 076 (95%CI: 0 055–0 127), respectively These results indicated that the COVID-19 infection rate was higher in persons with blood group A > O > B > AB Overall, the ABO blood group's vulnerability to COVID-19 infection was statistically significant (pooled p -value<0 001) Conclusion This meta-analysis offers a further indication of blood group A individuals' vulnerability to COVID-19 infection, and blood type AB are linked to a lower risk of COVID-19 infection
Systematic review and meta-analysis of the susceptibility of ABO blood group to COVID-19 infection
Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis. 2021;60(4):103169
BACKGROUND Numerous studies investigate the association between the ABO blood groups and the occurrence of COVID-19 infection; discordant findings were reported. Therefore, the purpose of this meta-analysis was to evaluate the existing evidence on the susceptibility of the ABO blood group to COVID-19 infection. METHODS Systematically searched published articles in PubMed, Google Scholar, Scopus, and EMBASE between 1 st January 2020 and 21 st March 2021. After quality control and the exclusion of irrelevant studies, 16 studies were included in the final analysis. RESULTS Although the random-effect meta-analysis revealed a large heterogeneity among studies, I 2 = 99.197 %. The pooled event rates and (95 % CIs) for A, O, B, and AB blood group were 0.459 (95 %CI: 0.358-0.441), 0.342 (95 %CI: 0.298-0.374), 0.180 (95 %CI: 0.150-0.214), and 0.076 (95 %CI: 0.055-0.127), respectively. These results indicated that the COVID-19 infection rate was higher in persons with blood group A > O > B > AB. Overall, the ABO blood group's vulnerability to COVID-19 infection was statistically significant (pooled p -value<0.001). CONCLUSION This meta-analysis offers a further indication of blood group A individuals' vulnerability to COVID-19 infection, and blood type AB are linked to a lower risk of COVID-19 infection.
ABO blood group influence COVID-19 infection: a meta-analysis
Journal of infection in developing countries. 2021;15(12):1801-1807
INTRODUCTION Previous studies have linked the relationship between ABO blood group and COVID-19 infection. However, existing evidence is preliminary and controversial. This meta-analysis sought to identify studies that describe COVID-19 and ABO blood group. METHODOLOGY A literature search was conducted from PubMed, Web of Science, MedRxiv, BioRxiv and Google Scholar databases. Members of cases and controls were extracted from collected studies. Pooled Odds ratio (OR) and 95% confidence interval (95%CI) were calculated and interpreted from extracted data. Publication bias and sensitivity analysis were also applied to confirm our discovery. RESULTS Total 13,600 patients and 3,445,047 controls were included in the study. Compared to other ABO blood group, blood group O was associated with a lower risk of COVID-19 infection (OR = 0.76, 95%CI 0.66-0.84), while blood group A and AB was associated with a higher risk (OR = 1.25, 95%CI 1.10-1.41; OR = 1.13, 95%CI 1.04-1.23, respectively). In the subgroup analysis, the relationship between blood group A, O and COVID-19 infection remained stable among Chinese, European and Eastern Mediterranean populations. In American population, blood groups B was linked with increased risk of COVID-19 infection (OR = 1.21, 95%CI 1.09-1.35). CONCLUSIONS Our data suggested that individuals with blood types A and AB are more susceptible to COVID-19, while people with blood type O are less susceptible to infection. More research is needed to clarify the precise role of the ABO blood group in COVID-19 infection to address the global question.
ABO blood group and COVID-19: an updated systematic literature review and meta-analysis
Blood Transfusion = Trasfusione Del Sangue. 2021
BACKGROUND Following the first reports in the literature, the association between the ABO blood group and SARS-CoV-2 infection has been investigated by a number of studies, although with varying results. The main object of this systematic review was to assess the relationship between the ABO blood group and the occurrence and severity of COVID-19. MATERIALS AND METHODS A systematic literature search using appropriate MeSH terms was performed through Medline and PubMed. The outcomes considered were the prevalence of the blood group O vs non-O types in SARS-CoV-2 infected and non-infected subjects, and the severity of SARS-CoV-2 infection according to ABO group. The methodological quality of the studies included in the analysis was assessed with the Newcastle-Ottawa Scale, and the overall quality of the available evidence using the GRADE system. Benchmarks used to evaluate the effect size were odd ratios (ORs) for case control studies and risk ratios (RRs) for cohort studies. RESULTS Twenty-one studies were included in the analysis. Overall, individuals with group O had a lower infection rate compared to individuals of non-O group (OR: 0.81; 95% CI: 0.75, 0.86). However, the difference in the effect size was significantly lower in cohort studies compared to case control studies. No evidence was found indicating an effect of the O type on the disease severity in the infected patients. DISCUSSION We have found low/very low evidence that group O individuals are less susceptible to SARS-CoV-2 infection compared to those in the non-O group. No evidence was found indicating an effect of the O type on disease severity in SARS-CoV-2 infection.
The impact of ABO blood groups on clinical outcomes and susceptibility to COVID-19: A retrospective study in an unselected population
BACKGROUND ABO blood groups have been linked to susceptibility to infection with certain microorganisms, including coronaviruses. We examined the relationship between blood group and clinical outcomes in individuals infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and compared their blood group distribution with the general population. METHODS At the inception of the pandemic, all individuals testing positive for SARS-CoV-2 in Kuwait were admitted to one designated coronavirus disease 2019 (COVID-19) hospital and enrolled in a prospective registry. Patients admitted from February 24 to May 27, 2020, were stratified according to blood group. As a control, blood groups of 3,730,027 anonymized individuals representing almost Kuwait's entire population were obtained from a national database. RESULTS Of 3305 SARS-CoV-2-positive patients, 37.1%, 25.5%, 28.9%, and 8.5% were groups O, A, B, and AB, respectively. Univariate analysis revealed no significant differences in severe clinical outcomes or death among the blood groups. However, multivariable analysis demonstrated that group A individuals had higher odds of developing pneumonia compared with non-group A (adjusted odds ratio 1.32, 95% confidence interval 1.02-1.72, p < .036). Compared with the general population, the COVID-19 cohort had a lower frequency of group O, equivalent frequency of A, and higher frequency of B and AB. No significant difference in the RhD group was found. CONCLUSION This study supports potential involvement of the ABO blood group system in predisposing to infection with SARS-CoV-2 in an unselected population. Examination of the mechanistic link between blood group and COVID-19 and its implications on controlling the current pandemic is warranted.
The association between ABO blood group and SARS-CoV-2 infection: A meta-analysis
Plos One. 2020;15(9):e0239508
At present, existing evidence about the association between SARS-CoV-2 infection and ABO blood group polymorphism is preliminary and controversial. In this meta-analysis we investigate this association and determine SARS-CoV-2 positive individuals' odds of having a specific blood group compared to controls. We performed a systematic search on MEDLINE and LitCovid databases for studies published through July 15, 2020. Seven studies met inclusion criteria for meta-analysis, including a total of 13 subgroups of populations (7503 SARS-CoV-2 positive cases and 2962160 controls). We analysed the odds of having each blood group among SARS-CoV-2 positive patients compared with controls. Random-effects models were used to obtain the overall pooled odds ratio (OR). Subgroup and sensitivity analyses were performed in order to explore the source of heterogeneity and results consistency. The results of our meta-analysis indicate that SARS-CoV-2 positive individuals are more likely to have blood group A (pooled OR 1.23, 95%CI: 1.09-1.40) and less likely to have blood group O (pooled OR = 0.77, 95%CI: 0.67-0.88). Further studies are needed to investigate the mechanisms at the basis of this association, which may affect the kinetics of the pandemic according to the blood group distribution within the population.