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The impact of ABO blood group on COVID-19 infection risk and mortality: A systematic review and meta-analysis.

ABSTRACT: The 2019 coronavirus disease (COVID-19) has become a global pandemic. Several studies report that ABO blood group polymorphism may be related to COVID-19 susceptibility and clinical outcomes; however, the results are controversial. We conducted a systematic review and meta-analysis to investigate whether ABO blood groups are associated with increased COVID-19 morbidity and mortality. A total of 715 articles were retrieved from seven databases. Ten articles were selected for meta-analysis after removal of duplicates and two levels of screenings. Overall, individuals with blood group A [odds ratio (OR) = 1.33, 95% confidence interval (CI) 1.14 to 1.56] and B (OR = 1.06, 95% CI 1.00 to 1.13) had a substantially higher risk of COVID-19, whereas this was not the case for blood group AB (OR = 1.07, 95% CI 0.88 to 1.30). Individuals with blood group O was not prone to develop the disease (OR = 0.71, 95% CI 0.60 to 0.84). Moreover, the risk of COVID-19 was significantly associated with the Rh-positive blood group (OR = 1.22, 95% CI 0.99 to 1.50). A meta-analysis of 5 studies suggested that blood group A was associated with a significantly increased risk of COVID-19 mortality (OR = 1.25, 95% CI 1.02 to 1.52). Mild publication bias was found in the included studies. This systematic review and meta-analysis indicated that blood groups A and B may be risk factors for COVID-19, whereas the blood group O appears to be protective. Blood group A may be related to unfavourable outcomes. Further rigorous and high-quality research evidence is needed to confirm this association.

SUBMITTER: Liu N

PROVIDER: S-EPMC7834371 | biostudies-literature |

REPOSITORIES: biostudies-literature

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ABO blood groups, COVID-19 infection and mortality.

Project description:BackgroundA recent study showed that the ABO gene, chr 9q34.2, which determines blood type, may affect COVID-19 disease severity, although this result has not been reproducible. A UK study of 2200 COVID-19 patients found no relationship of ABO blood type to disease severity. A Danish study identified ABO blood group as a risk factor for SARS-CoV-2 infection but not for hospitalization or death from COVID-19.AimIn the current study, we wished to analyze the relationship of ABO blood group and the ABO genetic locus to COVID-19 test positivity and mortality in subjects from the UK Biobank (UKB).MethodsABO blood type is from UKB data field 23165. Blood type was imputed for genotyped UK Biobank participants using three SNPs (rs505922, rs8176719, and rs8176746) in the ABO gene on chromosome 9q34.2. We analyzed the chromosome 9 snp rs657152 to assess the relationship of the ABO locus to COVID-19 test positivity and mortality.ResultsCOVID-19 test results (negative or positive) were not related to blood group in males (p = 0.977, two tailed Fisher exact test) or females (p = 0.548). COVID-19 outcomes (alive or died) were not related to blood group in males (p = 0.102, two tailed Fisher exact test) or females (p = 0.226). We found no significant relationship of rs657152 to COVID-19 test positivity or mortality.ConclusionWe were not able to confirm that ABO blood group influences risk of COVID-19 infection or outcome.

| S-EPMC8059281 | biostudies-literature

ABO blood group and risk of COVID-19 infection and complications: A systematic review and meta-analysis.

Project description: Not available

| S-EPMC8661771 | biostudies-literature

ABO blood group and COVID-19: an updated systematic literature review and meta-analysis.

Project description:BackgroundFollowing 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 methodsA 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.ResultsTwenty-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.DiscussionWe 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.

| S-EPMC8297670 | biostudies-literature

Association of ABO blood group with COVID-19 severity, acute phase reactants and mortality.

Project description:IntroductionCoronavirus disease 2019 (COVID-19) is the ongoing pandemic with multitude of manifestations and association of ABO blood group in South-East Asian population needs to be explored.MethodsIt was a retrospective study of patients with COVID-19. Blood group A, B, O, and AB were identified in every participant, irrespective of their RH type and allotted groups 1, 2,3, and 4, respectively. Correlation between blood group and lab parameters was presented as histogram distributed among the four groups. Multivariate regression and logistic regression were used for inferential statistics.ResultsThe cohort included 1067 patients: 521 (48.8%) participants had blood group O as the prevalent blood type. Overall, 10.6% COVID-19-related mortality was observed at our center. Mortality was 13.9% in blood group A, 9.5% in group B, 10% in group C, and 10.2% in AB blood group (p = 0.412). IL-6 was elevated in blood group A (median [IQR]: 23.6 [17.5,43.8]), Procalcitonin in blood group B (median [IQR]: 0.54 [0.3,0.7]), D-dimers and CRP in group AB (median [IQR]: 21.5 [9,34]; 24 [9,49], respectively). Regarding severity of COVID-19 disease, no statistical difference was seen between the blood groups. Alteration of the acute phase reactants was not positively associated with any specific blood type.ConclusionIn conclusion, this investigation did not show significant association of blood groups with severity and of COVID-19 disease and COVID-19-associated mortality.

| S-EPMC8670663 | biostudies-literature

COVID-19 host genetics and ABO blood group susceptibility.

Project description:Twenty-five susceptibility loci for SARS-CoV-2 infection and/or COVID-19 disease severity have been identified in the human genome by genome-wide association studies, and the most frequently replicated genetic findings for susceptibility are genetic variants at the ABO gene locus on chromosome 9q34.2, which is supported by the association between ABO blood group distribution and COVID-19. The ABO blood group effect appears to influence a variety of disease conditions and pathophysiological mechanisms associated with COVID-19. Transmission models for SARS-CoV-2 combined with observational public health and genome-wide data from patients and controls, as well as receptor binding experiments in cell lines and human samples, indicate that there may be a reduction or slowing of infection events by up to 60% in certain ABO blood group constellations of index and contact person in the early phase of a SARS-CoV-2 outbreak. The strength of the ABO blood group effect on reducing infection rates further depends on the distribution of the ABO blood groups in the respective population and the proportion of blood group O in that population. To understand in detail the effect of ABO blood groups on COVID-19, further studies are needed in relation to different demographic characteristics, but also in relation to recent data on reinfection with new viral variants and in the context of the human microbiome.

| S-EPMC10953747 | biostudies-literature

[Infection and thrombosis associated with COVID-19: Possible role of the ABO blood group].

Project description:BackgroundSARS-CoV-2 infection is clinically very heterogeneous, varying from asymptomatic to severe clinical conditions with a fatal outcome. Some studies suggests that the ABO blood group could be a biological marker of susceptibility for the development of the disease.Patients and methodsWe collected data from patients admitted with COVID-19 infection who had ABO blood group recorded, and analyzed the incidence by groups, compared with the global population in Navarre, as well as their main complications and evolution.ResultsGroup O was proportionally less represented in the hospitalized patients with respect to the global population, although the difference was not statistically significant. Group B had significantly higher rates of thrombotic complications and required more admissions in intensive care units.ConclusionThe study suggests a lower susceptibility to infection in group O and a higher risk of complications in group B. Studies with a larger sample size are required in order to obtain significant results.

| S-EPMC7346773 | biostudies-literature

Infection and thrombosis associated with COVID-19: Possible role of the ABO blood group.

Project description:BackgroundSARS-CoV-2 infection is clinically very heterogeneous, varying from asymptomatic to severe clinical conditions with a fatal outcome. Some studies suggests that the ABO blood group could be a biological marker of susceptibility for the development of the disease.Material and methodsWe collected data from patients admitted with COVID-19 infection who had ABO blood group recorded, and analyzed the incidence by groups, compared with the global population in Navarre, as well as their main complications and evolution.ResultsGroup O was proportionally less represented in the hospitalized patients with respect to the global population, although the difference was not statistically significant. Group B had significantly higher rates of thrombotic complications and required more admissions in intensive care units.ConclusionThe study suggests a lower susceptibility to infection in group O and a higher risk of complications in group B. Studies with a larger sample size are required in order to obtain significant results.

| S-EPMC7519708 | biostudies-literature

COVID-19 infection and complications according to ABO blood group in the elderly: A population-based subcohort and meta-analysis.

Project description:Background and objectivesIt is reported that ABO antibodies have a role in COVID-19 infection and severity; however, ABO antibody titres vary with advanced age. The aim was to analyse the association between ABO blood group and risk of COVID-19 infection and complications in elderly patients, and to contrast this data with findings in the overall adult population.Materials and methodsA prospective cohort study of the Navarre (Spain) population aged ≥60 years and a meta-analysis of published studies including participants of ≥60 years were carried out.ResultsIn the Navarre elderly population, a higher risk of COVID-19 infection was identified in the A versus non-A and O group and lower risk in O versus non-O, with no significant association between hospitalization, intensive care unit admission or mortality and any of the blood groups, results that coincide with those of the overall Navarre adult population. The meta-analyses using studies that included participants of ≥60 years demonstrated a higher risk of hospitalization and mortality in A versus non-A and a lower mortality risk with B versus non-B. Similar mortality results were found in the meta-analyses of the overall adult population.ConclusionThere are no relevant differences between the overall adult population and population aged ≥60 years in the risk of COVID-19 infection and severity according to ABO blood groups, suggesting that age-related changes in ABO would be of limited clinical significance.

| S-EPMC9349979 | biostudies-literature

ABO blood group association and COVID-19. COVID-19 susceptibility and severity: a review.

Project description:IntroductionThe SARS-CoV-2 pandemic has been affecting the health and economic, as well as social, life of the entire globe since the end of 2019. The virus causes COVID-19, with a wide range of symptoms among the infected individuals, from asymptomatic infection to mortality. This, along with a high infection rate, prompted efforts to investigate the potential mechanisms of the different clinical manifestations caused by SARS-CoV-2 among the infected populations.HypothesisOne of the possible mechanisms that has been reported is the ABO blood system polymorphism. Indeed, one of the major proposed mechanisms is the presence of naturally occurring anti-A antibodies in individuals of groups O and B, which could be partially protective against SARS-CoV-2 virions.Objective and methodThis article aimed to review the published data on the potential effect of the ABO blood group system on the susceptibility to COVID-19 and the disease progression and outcomes.ResultsThe reviewed data suggest that individuals of blood group A are at a higher risk of infection with SARS-CoV-2 and may develop severe COVID-19 outcomes, whereas blood group O is considered protective against the infection, to some extent. However, some of the available studies seem to have been influenced by unaccounted confounders and biases.ConclusionTherefore, further appropriately controlled studies are warranted to fully investigate the possible association between the ABO blood groups and COVID-19 susceptibility and severity.

| S-EPMC8437766 | biostudies-literature

ABO blood group system is associated with COVID-19 mortality: An epidemiological investigation in the Indian population.

Project description:BackgroundNovel coronavirus disease-19 (COVID-19) has spread worldwide, and to date presence of the virus has been recorded in 215 countries contributing 0.43 million of death. The role of blood groups in susceptibility/resistance to various infectious diseases has been reported. However, the association of blood groups with susceptibility to COVID-19 infections or related death are limited. In the present report, we performed an epidemiological investigation in the Indian population to decipher the importance of blood groups concerning susceptibility or mortality in COVID-19 infection.Materials and methodsData on COVID-19 infection and mortality was obtained from the website of the Government of India. Prevalence of ABO blood groups in different states and union territories of India were searched using different databases such as PubMed and Google Scholar. Relevant articles were downloaded, and data were extracted. Spearman's rank coefficient analysis was employed to study the correlation between blood group frequencies and COVID-19 infection or mortality rate.ResultsA significant inverse correlation was observed between the frequency of O blood group and the COVID-19 mortality rate (Spearman r=-0.36, P=0.03), indicating a possible protective role of O blood group against COVID-19 related death. In contrast, the prevalence of blood group B was positively correlated with COVID-19 death/million (Spearman r=0.67, P<0.0001), suggesting B blood type as a deleterious factor in COVID-19 infection.ConclusionsABO blood group system is associated with poor prognosis of COVID-19 infection. Blood group O may protects, and subjects with blood type B could be susceptible to COVID-19 mortality. However, further studies on COVID-19 infected patients in different population are required to validate our findings.

| S-EPMC7518849 | biostudies-literature

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