Manual de procesos y procedimientos para la gestión de la sangre, inmunohematología y hemoterapia / Manual of processes and procedures for blood management, immunohematology and hemotherapy

El presente manual de procesos y procedimientos documenta los servicios que se ofrecen en la atención al usuario interno y externo para la gestión de la sangre, inmunohematología y hemoterapia como parte del proceso de atención en salud integral e integrada a la persona en el curso de vida con enfoque de atención primaria en salud, describe el sistema de operación ofrecido en los establecimientos de salud, mediante el enfoque por procesos, fomentando así el desarrollo organizacional y el mejoramiento continuo para el cumplimiento de la misión institucional. Establece las bases para la ejecución de los procedimientos como parte de los procesos institucionales, unificando criterios de contenido que permite la sistematización de las actividades y la definición de la metodología para efectuarlas. Esta herramienta táctica y operativa, permite integrar las actividades y tareas de manera oportuna, para el logro de la prestación de servicios con calidad en los establecimientos de salud que lo necesiten, facilitando el cumplimiento de las normativas y lineamientos de programas especiales o por ciclo de vida vigentes en el Ministerio de Salud, así como la armonización con la sistematización y uso de herramientas tecnológicas que sea necesario implementar para volver más eficaz el trabajo del talento humano en salud

This manual of processes and procedures documents the services offered in the care of internal and external users for blood management, immunohematology and hemotherapy as part of the process of comprehensive and integrated health care for the person throughout the life course. With a focus on primary health care, it describes the operation system offered in health establishments, through the process approach, thus promoting organizational development and continuous improvement to fulfill the institutional mission. Establishes the bases for the execution of procedures as part of institutional processes, unifying content criteria that allows the systematization of activities and the definition of the methodology to carry them out. This tactical and operational tool allows the integration of activities and tasks in a timely manner, to achieve the provision of quality services in the health establishments that need it, facilitating compliance with the regulations and guidelines of special programs or by cycle of life in force in the Ministry of Health, as well as harmonization with the systematization and use of technological tools that need to be implemented to make the work of human talent in health more effective

Susceptibilité d'appartenance à un groupe sanguin spécifique du système Abo des personnes atteintes de COVID-19 à l'Institut national de Santé Publique (INSP) en 2020 / Susceptibility of ABOS blood groups to COVID-19 at the National Institute of Public Health (INSP) Of Mali In 2020

Introduction: Plusieurs auteurs ont suggéré une association entre le système ABO (SABO) et le risque d'infection au SRAS CoV-2. La présente étude avait pour objectif d'identifier la susceptibilité des groupes sanguins du SABO au COVID-19à l'Institut National de Santé Publique (INSP) du Mali. Matériel et méthodes : Il s'agissait une étude cas-témoins non appariée. Les cas (402) étaient des patients COVID-19 et les témoins (5438) des pèlerins musulmans tous ayant fait le groupage sanguin ABO à l'INSP. Une régression logistique fut réalisée afin d'identifier les facteurs associés au statut infectieux à SRAS-CoV-2en utilisant le logiciel SPSS version25. Résultats: Les groupes sanguins avaient les fréquences suivantes : O(34%), B(30%), A(28%), AB(8%) pour les cas et O(42%), B(27%), A(25%), AB(6%) pour les témoins. Le statut COVID-19 positif n'était pas significativement associé aux groupes sanguins A(OR=1,17; IC95%[0,93-1,47]), B(OR=1,11; IC95%[0,89-1,39]) et AB(OR=1,41; IC95%[0,97-2,06]). Cependant, les sujets du groupe sanguin O étaient 28 fois moins susceptibles de faire la COVID-19 que les non O(OR=0,72; IC95%[0,58-0,89). Conclusion: Les résultats suggèrent que les personnes du groupe sanguin O étaient moins susceptibles de faire l'infection par le SRAS CoV-2 que les non O. Cela ne devrait pas influer sur l'utilisation des mesures barrières au sein des groupes SABO.

Introduction: Several authors have suggested an association between the ABO system (ABOS) and the risk of SARS CoV-2 infection. The objective of the present study was to identify the susceptibility of ABOS blood groups to COVID-19 at the National Institute of Public Health (INSP) of Mali. Material and methods: This was an unpaired case-control study. The cases (402) were COVID-19 patients, and the controls (5438) were Muslim pilgrims, all of whom had undergone ABO blood grouping at the INSP. Logistic regression was performed to identify factors associated with SARS-CoV-2 infection status using SPSS version25 software. Results: Blood types had the following frequencies: O(34%), B(30%), A(28%), AB(8%) for cases and O(42%), B(27%), A(25%), AB(6%) for controls. COVID-19 positive status was not significantly associated with blood groups A(OR=1.17; CI95%[0.93-1.47]), B(OR=1.11; CI95%[0.89-1.39]) and AB(OR=1.41; CI95%[0.97-2.06]). However, blood group O subjects were 28 times less likely to have COVID-19 than non-O(OR=0.72; CI95%[0.58-0.89). Conclusion: The results show that blood group O individuals were less likely to have SARS CoV-2 infection than non-O individuals. This should not affect the use of barrier measures in ABOS groups.

Retrospective Analysis of Irregular Antibodies Causing Hemolytic Disease of the Fetus and Newborn in Jiangxi Province / 中国实验血液学杂志

OBJECTIVE@#To analyze the characteristics of antibody-specific distribution, laboratory detection results of hemolytic disease of the fetus and neonatal(HDFN) caused by irregular blood group antibodies other than ABO, and its correlation with the clinical situation.@*METHODS@#The non-ABO-HDFN cases in our hospital from October 2012 to December 2021 were selected as the research objects, and the cases diagnosed with ABO-HDFN in the same period were randomly selected as the control group, and the data of antibody specific distribution, total bilirubin, direct antibodies, maternal history, age of the children, the presence or absence of combined ABO-HDFN, and whether to exchange/transfuse blood were retrospectively analyzed. The characteristics of non-ABO-HDFN in Jiangxi province were analyzed.@*RESULTS@#The detection rate of non-ABO-HDFN in Jiangxi province increased. Among 187 non ABO-HDFN cases, the highest percentage of Rh-HDFN was detected (94.6%). Compared with the control group of ABO-HDFN, the non-ABO-HDFN had higher mean integral value of direct antibody, higher peak total bilirubin, and longer duration. Anti-M-HDFN may have severe disease but the direct antibody weak positive/negative, it was easy missed in clinical and delayed the treatment. There is no correlation between the specificity of irregular antibodies, the sex of the child, the mother's previous childbirth history, the presence or absence of combined ABO-HDFN and the need for blood exchange/transfusion(P>0.05).@*CONCLUSION@#The irregular antibodies of causing non ABO-HDFN in Jiangxi area are mainly Rh blood group system, followed by MNS blood group system. Understanding the characteristics of HDFN disease, serological features and the correlation with clinical indexes will help to detect and treat non ABO-HDFN in time and reduce the risk of complications.

Analysis of Irregular Blood Group Antibody Distribution and Blood Transfusion Efficacy in Patients with Malignant Tumor / 中国实验血液学杂志

OBJECTIVE@#To investigate the distribution of irregular blood group antibodies in patients with malignant tumors, and to analyze the relationship between it and efficacy of blood transfusion in patients.@*METHODS@#5 600 patients with malignant tumors treated in Shanxi Bethune Hospital from January 2019 to December 2021 were selected as the research subjects. All patients received blood transfusion, and cross matching test was conducted before blood transfusion, irregular antibody results of patients were tested; the irregular distribution of blood group antibodies was observed, and the relationship between it and efficacy of blood transfusion in patients was analyzed.@*RESULTS@#Among 5 600 patients with malignant tumors, 96 cases were positive for irregular antibody, and the positive rate was 1.71%; the main blood group systems involved in the irregular antibody positive of 96 patients with malignant tumors were RH, MNSs and Duffy system, among which Rh blood group was the most common, and the proportion of anti-E was the highest; among the malignant tumor patients with positive blood group irregular antibody, the proportion of female was higher than that of male; the proportion of patients aged >60 years was the highest, followed by patients aged >40 and ≤50 years, and the proportion of patients aged 18-30 years was the lowest; the patients with positive blood group irregular antibody were mainly in blood system (including lymphoma), digestive system, reproductive and urinary system; the positive rate of irregular antibody of patients in the ineffective group was higher than that of patients in the effective group, the difference was statistically significant (P<0.05). Logistic regression analysis results showed that, irregular antibody positive was a risk factor for ineffective blood transfusion in patients with malignant tumor (OR>1, P<0.05).@*CONCLUSION@#The irregular blood group antibody positive of patients with malignant tumor are mostly female, and the proportion of patients aged >60 is the highest, which is mainly distributed in malignant tumors of blood system, digestive system and urogenital system, and the positive blood group irregular antibody is related to the efficacy of blood transfusion in patients.

Serological characteristics and molecular mechanism of an individual with p phenotype / 中华医学遗传学杂志

OBJECTIVE@#To analyze the serological characteristics and molecular mechanism for an individual with p phenotype.@*METHODS@#An individual with p phenotype upon blood group identification at Jiaxing Blood Center in May 2021 was analyzed. ABO, RhD and P1PK blood groups and irregular antibodies in her serum were identified using conventional serological methods. The encoding region of α1, 4-galactosyltransferase gene (A4GALT) encoding P1 and Pk antigens was analyzed by polymerase chain reaction-sequence-based typing (PCR-SBT).@*RESULTS@#The individual was A group, RhD positive and had a p phenotype of the P1PK blood group system. Anti-PP1Pk was discovered in her serum. Sequencing analysis revealed that she has harbored a homozygous c.343A>T variant of the A4GALT gene.@*CONCLUSION@#The homozygous c.343A>T variant of the A4GALT gene probably underlay the p phenotype in this individual.

Investigation of ABO and RhD blood groups in childbearing age people in rural areas of Yunnan Province / 中华预防医学杂志

The participants in this study were 20-49 years old rural childbearing age people who received the National Free Preconception Health Examination Project (NFPHEP) in Yunnan Province during 2013 to 2019. The proportion of ABO and RhD blood groups among different ethnic groups and different areas were calculated. The proportion of 2 748 131 participants with blood group A phenotype was highest (32.60%), followed by O (30.60%), B (27.33%) and AB (9.47%). In the RhD blood system, the proportion of the RhD positivity (RhD+) and RhD negativity (RhD-) group were 99.29% and 0.71% respectively. The proportions blood groups were significantly different among ethnic groups and areas (all P<0.001). Among 18 ethnic groups with more than 3 000 participants, Yao (42.75%), Bouyei (40.58%) and Dai (40.37%) ethnic groups had higher proportion of blood group O phenotype than other ethnic groups. Wa ethnic groups had highest proportion of the A (40.15%) and AB phenotypes (11.23%). Miao ethnic group (34.70%) and Lahu ethnic group (34.42%) had higher proportion of blood group B phenotype than other ethnic groups. Wa ethnic group had the highest proportion of RhD-group (1.88%). In all 16 prefectures of Yunnan, the proportion of blood group O phenotype was highest in Xishuangbanna Dai Autonomous Prefecture (40.27%). Baoshan city (36.39%), Lincang city (36.22%) and Dali Bai autonomous prefecture (36.06%) had higher proportion of blood group A phenotype than other regions. Diqing Tibetan Autonomous Prefecture (30.83%) and Qujing city (30.48%) had higher proportion of blood group B phenotype than other areas, while Zhaotong city had a highest proportion of blood group AB phenotype (11.19%). The proportion of RhD-group was highest in Honghe hani and Yi nationality autonomous prefecture(1.37%). The A RhD+(39.36%), A RhD-(0.78%), AB RhD+(11.03%), AB RhD-(0.20%) and O RhD-(0.48%) blood groups were higher proportion in Wa ethnic group than in other ethnic groups (P<0.001).

Correlation Analysis of Hemolytic Transfusion Reaction Induced by Low Titer Antibody / 中国实验血液学杂志

OBJECTIVE@#To establish the diagnostic process of low titer blood group antibody in the occurrence of adverse reactions of hemolytic transfusion.@*METHODS@#Acid elusion test, enzyme method and PEG method were used for antibody identification. Combined with the patient's clinical symptoms and relevant inspection indexes, the irregular antibodies leading to hemolysis were detected.@*RESULTS@#The patient's irregular antibody screening was positive, and it was determined that there was anti-Lea antibody in the serum. After the transfusion reaction, the low titer anti-E antibody was detected by enhanced test. The patient's Rh typing was Ccee, while the transfused red blood cells were ccEE. The new and old samples of the patient were matched with the transfused red blood cells by PEG method, and the major were incompatible. The evidence of hemolytic transfusion reaction was found.@*CONCLUSION@#Antibodies with low titer in serum are not easy to be detected, which often lead to severe hemolytic transfusion reaction.

Frequency of antigen Dia on the blood donor population of the Hemocenter coordinator of the Hemopa Foundation

ABSTRACT Introduction: Erythrocyte phenotyping is a very important test in the adoption of prophylactic measures to reduce transfusion reactions/alloimmunizations in polytransfused patients. The blood group Diego, in its current, form has 22 antigens, of which 4 are immunogenic, being Dia/Dib and Wra/Wrb, while the others are less expressive. The antigen Dia is of low incidence among whites and blacks, however, it is common in the South American indigenous and Asian Mongolian populations. It is also considered a system of clinical importance for its immunogenicity. Method: The present study aimed to carry out a retrospective and descriptive survey of the frequency of the Dia antigen in the blood donor population at the HEMOPA Foundation Coordinating Blood Center from 12/2018 to 1/2000. The data obtained were from the HEMOPA Foundation SBS Progress and SBS WEB Systems databases. Results: During this period, 941,744 blood bags were collected and, of these, 930 bags were phenotyped for the Dia antigen, of which 842 were negative and 88 (9.7%) positive. The research showed that, among the positive donors for the antigen Dia, 88.6% were brown, 3.4%, black and 8%, white. In the statistical analysis, the frequency observed was higher in browns. Conclusion: In the present investigation, we concluded that our region has a relatively higher frequency of the Dia antigen, when compared to the rest of Brazil, and it occurs more often in browns.

Comparación de la prevalencia del grupo sanguíneo A en cáncer de estómago y población donante de sangre / Comparison of the prevalence of blood group A in gastric cancer patients and blood donors

RESUMEN Antecedentes: el cáncer gástrico constituye una enfermedad con una alta incidencia y mortalidad en Uruguay. El grupo sanguíneo A ha sido considerado un factor de riesgo así como de mayor prevalencia en esta enfermedad. Objetivo: El objetivo del trabajo es comparar el porcentaje entre el grupo sanguíneo A en pacientes con diagnóstico de cáncer gástrico y población donante de sangre en Uruguay. Material y métodos: se trata de un estudio observacional y retrospectivo. El tamaño muestral se determinó mediante la fórmula de comparación de proporciones con un nivel de confianza de 95% y una potencia de 80%. El número calculado fue de 149 para cada grupo. Se incluyeron todos los pacientes del Hospital Maciel y la Cooperativa Médica de Florida que cumplieron con los criterios de ingreso y una población de donantes de sangre de ambas instituciones. El análisis se realizó mediante la prueba de χ2 (chi cuadrado) estableciéndose un nivel de significación de 0,05. Resultados: se incluyeron 153 pacientes y usuarios en cada grupo. El grupo sanguíneo A presentó menor porcentaje en los pacientes con cáncer gástrico (35,9%) en relación con la población donante de sangre (36,6%). La diferencia no fue estadísticamente significativa entre los grupos estudiados. Conclusiones: se encontró que no hay diferencia significativa entre los porcentajes del grupo sanguíneo A de los grupos comparados.

ABSTRACT Background: Gastric cancer has high incidence and mortality in Uruguay. Blood group A has been considered a risk factor for gastric cancer and has high prevalence in this disease. Objective: The aim of this study is to compare the percentage of blood group A in patients with gastric cancer and in blood donors in Uruguay. Material and methods: We conducted an observational and retrospective study. We used the sample size calculation for comparing proportions with a confidence of 95% and 80% power. The number calculated was 149 for each group. We included all the patients from Hospital Maciel and Cooperativa Médica de Florida who met the admission criteria and a population of blood donors from both institutions. The chi-square test was used and a p value < 0.05 was considered statistically significant. Results: A total of 153 patients and blood donors were included in each group. Blood group A was less common in gastric cancer patients than in blood donors (35.9% vs. 36.6%). The difference was not statistically significant between the groups studied. Conclusions: We did not find any significant difference in the percentage of blood group A in the groups compared.

Caracterización inmunogenética de donantes cadavéricos cubanos en el año 2019 / Immunogenetic characterization of Cuban cadaveric donors in 2019

Introducción: El trasplante es la opción terapéutica más favorable para las personas con insuficiencia renal crónica. El donante puede ser cadavérico o donante vivo, emparentado o no. Los resultados del trasplante están en relación con varios factores inmunológicos y no inmunológicos. Objetivo: Caracterizar inmunogenéticamente a los donantes cadavéricos cubanos para trasplante renal. Métodos: Se realizó un estudio transversal y descriptivo de los donantes cadavéricos durante el año 2019. Se analizó la región de procedencia, sexo, color de la piel y rangos de edades de los donantes, así como, grupo sanguíneos ABO y Rhesus Rh; serología para VIH, Virus de hepatitis B(VHB) y Virus de hepatitis C (VHC); y hábitos tóxicos. Resultados: Se estudió un total de 95 donantes cadavéricos, 62 provenientes del occidente y 33 del centro del país. El 63,2 por ciento fueron masculinos y 36,8 por ciento femenino. El grupo de edad de mayor frecuencia fue 40 - 60 años y la edad media de 49,45 años. El 58,95 por ciento de los pacientes fueron de grupo sanguíneo O; 30,53 por ciento grupo A y los grupos B y AB tuvieron 5,26 por ciento de prevalencia; y solo 8 fueron Rh negativos. Todos tuvieron serología para VIH, VHB y VHC negativas. Las enfermedades asociadas más frecuentes fueron la hipertensión arterial y la diabetes mellitus. Conclusiones: Los donantes cadavéricos durante el año 2019 mostraron características similares a las reportadas por otros estudios. El aumento de las edades de los donantes incide en la aparición de enfermedades asociadas y esto pudiera repercutir en el resultado del trasplante(AU)

Introduction: Transplantation is the most favorable therapeutic option for people with chronic renal failure. The donor can be a cadaveric or living donor, related or not. Transplant outcomes are related to various immunological and non-immunological factors. Objective: To characterize Cuban cadaveric donors for renal transplantation Materials and methods: A cross-sectional and descriptive study of cadaveric donors was carried out during the year 2019. The region of origin, sex, skin color and age ranges of the donors were analyzed, as well as ABO and Rhesus Rh blood groups; serology for HIV, Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV), and toxic habits. Results: A total of 95 cadaveric donors were studied, 62 from the West and 33 from the Center of the country. 63.2 percent were male and 36.8 percent female due to the most frequent age group being 40-60 years and the mean age of 49.45 years. 58.95 percent of the patients were of blood group O, 30.53 percent group A and groups B and AB had 5.26 percent prevalence; and only 8 were Rh negative. All had negative serology for HIV, HBV and HCV. The most frequent associated diseases were arterial hypertension and diabetes mellitus. Conclusions: The cadaveric donors during the year 2019 showed characteristics similar to those reported by other studies. The increase in the age of the donors affects the appearance of associated diseases and this could affect the result of the transplant(AU)

Frecuencia de grupos sanguíneos ABO y RhD, en universitarios de El Alto ­ Bolivia / Frequency of ABO and RhD blood groups in university students in El Alto - Bolivia

INTRODUCCIÓN: los sistemas sanguíneos continúan siendo de gran importancia en múltiples disciplinas como la medicina transfusional, genética poblacional, medicina forense, trasplante de órganos entre otras, estas se basan en la determinación de los grupos sanguíneos ABO y Rh. El siguiente trabajo analiza la fenotipificación eritrocitaria en un grupo de estudiantes de la carrera de Bioquímica y Farmacia de 5to, 6to y 7mo semestre, Universidad Franz Tamayo (UNIFRANZ) sede El Alto - Bolivia. MATERIALES Y MÉTODOS: se realizó un estudio descriptivo de serie de casos, determinando los sistemas ABO y RhD, para las pruebas directa e indirecta a fin de evitar discrepancias; utilizando como soporte la técnica de microplaca, regida a controles de calidad en Inmunohematología. RESULTADOS: los resultados mostraron que el 86% eran mujeres, el grupo etario dominante esta entre 18 a 25 años de edad. El sistema ABO determinó el mayor porcentaje al grupo O con un 93%, destacando que no se encontró el grupo AB en el grupo de estudio. El sistema RhD, tuvo 100% de positivos, no encontrándose fenotipos RhD negativo ni variantes ni parciales. CONCLUSIÓN: la fenotipificación de grupos sanguíneos tanto directa e indirecta, a través de la plataforma de microplaca ayuda a evitar errores y discrepancias, tal como lo recomienda el Manual de Inmunohematología en servicios de sangre en Bolivia.

INTRODUCTION Blood systems continue to be of great importance in multiple disciplines such as transfusion medicine, population genetics, forensic medicine and organ transplantation, which are based on the determination of ABO and Rh blood groups. The following work analyzes the erythrocyte phenotyping in a group of students of Biochemistry and Pharmacy of 5th, 6th and 7th semesters, UNIFRANZ, El Alto. MATERIALS AND METHODS A descriptive case series study was carried out, determining the ABO and RhD systems for direct and indirect tests in order to avoid discrepancies; using the microplate technique as support, according to quality controls in Immunohematology. RESULTS The results showed that 86% were women, the dominant age group was between 18 and 25 years of age. The ABO system determined the highest percentage of group O with 93%, highlighting that the AB group was not found in the study group. The RhD system was 100% positive, with no RhD negative phenotypes, neither variant nor partial. CONCLUSION The phenotyping of blood groups, both direct and indirect, through the microplate platform helps to avoid errors and discrepancies, as recommended by the Manual of Immunohematology in blood services in Bolivia.

Asociación del grupo sanguíneo ABO con complicaciones en covid-19: revisión sistemática y meta-análisis / Asociation between abo blood groups and covid-19 complications: systematic review and meta-analysis

Introducción: los grupos sanguíneos ABO han sido utilizados como marcadores de desenlace en diferentes enfermedades, otorgando al grupo O un factor protector y al A uno de riesgo. Durante el brote de SARS CoV-1 se planteó la posible relación entre riesgo de infección y tipo sanguíneo; se presume que en la pandemia por COVID-19 exista una relación entre determinados desenlaces y los grupos ABO. Objetivo: determinar la asociación entre los diferentes grupos sanguíneos y los desenlaces de mortalidad, ingreso a cuidados intensivos y requerimiento de intubación orotraqueal (IOT) en población con infección por COVID-19. Materiales y métodos: revisión sistemática y metanálisis entre enero 2020 y marzo 2021 en las bases de datos MEDLINE, EMBASE, SCOPUS, Latindex y LILACS, identificando los desenlaces mencionados en pacientes con COVID-19. Resultados: se incluyeron 16 estudios, la mayoría retrospectivos multicéntricos. Se evidenció que pacientes con grupo sanguíneo A tienen mayor riesgo de mortalidad (OR 1.08 ;1.01-0.17), frente al ingreso a UCI no hubo diferencia estadística significativa entre los grupos sanguíneos. Se encontró que el AB representa un factor de riesgo para intubación orotraqueal (OR 1.42 IC95% 1.02-1.96), en tanto que el A demostró proteger contra este desenlace (OR 0.84 IC95%0.73-0.97). Conclusiones: hay evidencia sobre la relación entre el grupo sanguíneo y los desenlaces, asociada con la infección por SARS-CoV-2. Se requieren estudios prospectivos que evalúen grupo sanguíneo, RH y desenlaces específicos.

Introduction: ABO blood groups have been used as outcome markers in various diseases, conferring group O a protective factor and group A a risk factor. During the SARS CoV-1 outbreak, it was suggested that blood type appeared to have a relationship with the risk of infection; it is believed that in the COVID-19 pandemic, ABO blood types, are relevant for certain outcomes. Objective: to determine the association between blood types and death, admission to intensive care and risk of intubation among COVID-19 patients. Materials and methods: a systematic review and meta-analysis from MEDIA, EMBASSY, SCOPUS, Latindex and LILACS databases, identifying the abovementioned outcomes among COVID 19 patients, conducted between January 2020 and March 2021. Results: 16 studies were included, most of them retrospective multicenter studies. It was evidenced that patients with blood group A have a higher mortality risk (OR 1.08:1.01-0.17). There was no statistically significant difference between blood groups for ICU admission. AB was found to be a risk factor for intubation (OR 1.42: CI95% 1.02 -1.96), while type A had a protective effect against this outcome (OR 0.84: CI95% 0.73 -0.97). Conclusions: there is evidence on a relationship between blood groups and outcomes in SARS CoV-2 infection. Prospective studies evaluating ABO and Rh(D) blood types and specific outcomes, are required.

The Establishment and Application of Flow Cytometry on the Detection of Jka Antigen in Kidd Blood Group / 中国实验血液学杂志

OBJECTIVE@#To establish a based method flow cytometry to identify the antigen Jka in human red blood cells (RBCs) and verify its accuracy.@*METHODS@#A total of 96 blood samples were enrolled in the study randomly from the voluntary blood donors in Shenzhen Blood Center. The RBCs were incubated with IgG anti-Jka primary antibody, and then labeled with the secondary antibody anti-IgG-Alexa Fluor 647. The fluorescence histograms of each sample were obtained by flow cytometry. Serological agglutination test was used to compare the accuracy of flow cytometry in the detecting of antigen Jka, while PCR-SSP and gene sequencing genotyping were used to verify the accuracy of flow cytometry in the detecting of the antigen in human RBCs.@*RESULTS@#The results of flow cytometry for antigen Jka in human RBCs were consistent with those from serological tests. Samples that demonstrated higher serological agglutination intensity also showed higher fluorescence activity, which indicate more stronger of Jka antigen. The sensitivity of flow cytometry was higher than that of serological test; especially in distinguish Jka weak and negative samples. Flow cytometric results of all samples were consistent with the genotyping results, which confirmed the accuracy of flow cytometry.@*CONCLUSION@#The study established a new flow cytometry-based method successfully for the identification of Jka antigen of Kidd blood group in human RBCs. The Kidd blood group antigen Jka of different intensities can be accurately distinguished by the technique.

Preliminary Study on Screening and Identification of Lewis a Antigen Mimic Epitope in Alpaca Phage Display Nanobody Library / 中国实验血液学杂志

OBJECTIVE@#To establish a new method for synthesizing Lewis blood group antigens, that is, the mimotopes of Lewis blood group antigens were screened by using an alpaca phage display nanobody library.@*METHODS@#We selected mimotopes of the Lewis a (lea) antigen by affinity panning of an alpaca phage display nanobody library using a monoclonal anti-lea antibody. Enzyme-linked immunosorbent assay (ELISA) was used to test the affinity of the positive clones for the monoclonal anti-lea antibody, and the high-affinity positive clones were selected for sequencing and synthesis. Finally, the sensitivity, specificity and reactivity of the synthesized lea mimotope in clinical samples were verified by ELISA.@*RESULTS@#A total of 96 phage clones were randomly selected, and 24 were positive. Fourteen positive clones with the highest affinity were selected for sequencing. The result showed that there were 5 different sequences, among which 3 sequences with the highest frequency, largest difference and highest affinity were selected for expression and synthesis. The sensitivity and specificity of lea mimic antigen by ELISA showed that, the minimum detection limit of gel microcolumn assay (GMA) and ELISA method were 25 times different, and the lea mimic antigen had no cross reacted with the other five unrelated monoclonal antibodies(P<0.001). Finally, 30 clinical plasma samples were analyzed. The mean absorbance of the 15 positive plasma samples was significantly higher than that of the 15 negative plasma samples (P=0.02). However, the positive signal values of the clinical samples were much lower than those of the monoclonal antibodies.@*CONCLUSION@#A new method of screening lea mimic antigen by using alpaca phage nanoantibody library has been established, which is expected to realize the screening of lea mimotopes, thus realizing the application of high-sensitivity detection methods such as ELISA and chemiluminescence in blood group antibody identification.

Interaction of dental anxiety and ABO secretor status of blood group on dental caries in a group of children / Interação da ansiedade odontológica e o status secretor do grupo sanguíneo ABO na carie dental em um grupo de crianças

Objective: To evaluate the interaction of the dental anxiety precedents at the first dental examination and the AB secretor status of blood groups (A, B, AB, and O) on dental caries experience and severity in a group of school children. Material and Methods: This is a cross-sectional study included 81 healthy children aged 6-8 years from primary schools in Baghdad; with negative previous dental visit. Dental anxiety represented by physiological measures was measured by pulse oximeter. Dental caries experience and severity was recorded. Unstimulated salivary samples were taken from the children to determine the salivary secretor status for AB blood type. Results: The anxiety was decreased as age increases; boys were more anxious than girls; and more anxious children were found in non-secretor group; Dental caries was higher in non-secretor anxious children all with non-significant difference. Conclusion: There is little evidence that the AB secretor status and anxiety to have influence on dental caries experience and severity, as there are many factors may interact to propagate the caries experience and severity. (AU)

Objetivo: Avaliar a interação dos precedentes da ansiedade odontológica no primeiro atendimento e o status secretor do grupo sanguíneo ABO (A, B, AB, and O) na experiência e severidade de carie dental em um grupo de crianças em fase escolar. Material e Métodos: Este estudo cruzado incluiu 81 crianças saudáveis, com 6-8 anos de idade de escola primária em Baghdad; sem atendimento odontológico prévio. A ansiedade odontológica representada por medidas fisiológicas foi avaliada pelo oxímetro de pulso. A experiência à cárie bem como a severidade foram registradas. Amostras de saliva não estimulada foram coletadas das crianças para se determinar o status secretor salivar para tipo sanguíneo AB. Resultados: A ansiedade diminuiu conforme a idade aumentava; meninos foram mais ansiosos do que as meninas; e crianças mais ansiosas foram encontradas no grupo não secretor. A cárie dental foi maior no grupo não secretor de crianças ansiosas sem diferença significante. Conclusão: Há uma pequena evidência de que o status secretor AB e ansiedade tem influência na experiência e na severidade da cárie dental, assim como há vários fatores que podem interagir para propagar a experiência de cárie e sua severidade.(AU)

Association of COVID-19 severity with vitamin D and blood group

Abstract: Vitamin D is a hormone which plays a vital role in immune response regulation, including the prevention of inflammation and autoimmunity. Insufficient vitamin D may increase the risk of infection. Vitamin D deficiency is not the only factor linked to an elevated risk of COVID-19 infection. Recent studies have discovered a link between SARS-COV-2 infection risk and blood type. This study was aimed to examine the association of vitamin D and blood groups with the severity of COVID-19. A retrospective study was conducted on 224 confirmed COVID-19 patients, aged between 18 and 89 years old. Patients were divided into three groups (asymptomatic, moderate, and severe cases), and serum 25(OH)D concentration and blood group were analyzed for all the patients. Data of the severe cases were obtained from Souq Althalath Isolation Center, Tripoli, Libya, while moderate and asymptomatic cases were obtained from Abushusha Polyclinic and Aldahmani COVID Filtration Center, during 22nd February 2021 and 28th April 2021 and serum 25(OH)D concentration and blood group were statistically analyzed for all the patients. The percentages of males andfemales were found to be 47.3% and 52.7%, respectively. Disease severity was distributed as follows: 12.5% asymptomatic, 44.6 % moderate and 42.9% severe. Most of the severe cases had vitamin D deficiency (88.5%). Among the severely ill patients, 39.6% had blood group A and 09.4% had group O, while 22.9%, and 28.1% had blood group B and AB, respectively. In contrast, among the asymptomatic patients, only 7.1% had group A and 85.7% had group O. Overall, the difference in the distribution pattern of blood group in the three severity categories was highly significant (p < 0.001). The prevalence of Rh positivity among asymptomatic, moderate and severe cases was 78.6%, 76.0%, and 60.4%, respectively. This study concludes that insufficient vitamin D levels might influence the severity of COVID-19. COVID-19 patients with blood group A and those who are Rh-positive could be more vulnerable to developing COVID-19 severity

Anticuerpos irregulares en donantes de sangre / Anticuerpos irregulares en donantes de sangre Irregular antibodies in blood donor

Introducción: El sistema inmunológico puede reconocer una gran cantidad de antígenos cuando está expuesto a ellos. Los linfocitos B producen gran variedad de anticuerpos, con el fin de generar la especificidad de los receptores para el reconocimiento de dichos antígenos. La presencia de anticuerpos irregulares, es una de las causas de reacciones adversas transfusionales por incompatibilidad entre donante y receptor. Objetivo: Describir la genética, estructura y función de los anticuerpos irregulares en los donantes de sangre. Métodos: Se llevó a cabo una revisión de la literatura, en idioma inglés y español, a través de bases de datos como Pubmed, ScienceDirect, NCBI, Redalyc y SciElo de artículos publicados en los últimos 10 años. Análisis y síntesis de la información: El sistema inmunológico genera una gran diversidad de anticuerpos mediante el proceso de recombinación somática entre los segmentos Variables (V), de diversidad (D) y de unión (J) de la línea germinal de las inmunoglobulinas, como mecanismo de defensa del organismo frente a sustancias o antígenos extraños. Los anticuerpos irregulares son aquellos diferentes al sistema sanguíneo ABO y los más comúnmente encontrados en los donantes de sangre son anti-D, anti-E, anti-K y anti-M. Conclusiones: La importancia clínica de los anticuerpos irregulares en donantes se basa en su asociación con las reacciones hemolíticas, dada la capacidad que tienen los antígenos de algunos grupos sanguíneos para generar anticuerpos de tipo IgG que causan lisis prematura de los eritrocitos(AU)

Introduction: The immune system can recognize a large number of antigens when it is exposed to them; B Lymphocytes produces a great variety of antibodies, in order to generate the specificity of the receivers for the recognition of said antigens. The presence to irregular antibodies is one of the causes to the adverse reactions to the transfusion when for blood incompatibility between donor and receptor. Objective: To describe the genetics, structure and function of irregular antibodies in blood donors. Methods: A literature review was carried out, in English and Spanish, through databases such as Pubmed, ScienceDirect, NCBI, Redalyc and Scielo of articles published in the last 10 years. Analysis and synthesis of information: The immune system generates a great diversity of antibodies through the somatic recombination process between the Variable (V), diversity (D) and joining (J) segments of the germ line of immunoglobulins, as a defense mechanism of the organism against foreign substances or antigens. Irregular antibodies are those other than the ABO blood system and those most commonly found in blood donors are anti-D, anti-E, anti-K, and anti-M. Conclusions: The clinical significance of irregular antibodies in donors is based on their association with hemolytic reactions, due to the ability of antigens in some blood groups to generate IgG-type antibodies that cause premature erythrocyte lysis(AU)

Enfermedad hemolítica del feto y del recién nacido por aloanticuerpos contra el antígeno M / Hemolytic disease in fetuses and newborns due to antibodies against the M-antigen

Resumen | Hay pocos reportes de enfermedad hemolítica del feto y del recién nacido causada por aloanticuerpos contra el sistema de antígenos MNS, especialmente, porque los anticuerpos que se generan contra estos antígenos son del tipo IgM, los cuales tienen reactividad a temperaturas inferiores a los 37 °C, y, por lo tanto, no son de importancia clínica. A pesar de ello, se han reportado casos con presencia de anticuerpos anti-M de tipo IgG causantes de la enfermedad hemolítica del recién nacido e, incluso, casos de muerte intrauterina por incompatibilidad materno-fetal en el sistema MNS. El proceso hemolítico se asemeja al causado por los anticuerpos anti-Kell, con anemia progresiva por supresión hematopoyética que induce la destrucción de precursores hematopoyéticos en la médula ósea y ausencia de reticulocitos en la periferia. Se reporta el caso de una mujer con 38,5 semanas de gestación, que presentó discrepancia en la hemoclasificación directa y en la inversa. Como resultado, el recién nacido fue positivo en la prueba de Coombs directa sin que existiera incompatibilidad ABO con la madre. La correlación de estos resultados llevó a la detección de un anticuerpo anti-M en el suero materno. El diagnóstico definitivo fue posible gracias a la discrepancia en la hemoclasificación de la sangre materna. A pesar de que los anticuerpos anti-M usualmente no desempeñan un papel importante en la enfermedad hemolítica perinatal, este caso resalta la importancia de determinar la presencia de diferentes anticuerpos que pueden ser de vital interés a la hora de prevenir resultados graves asociados con dicha condición. Además, abre la puerta a nuevas recomendaciones relacionadas con la tamización y el tratamiento temprano de la hemólisis en los recién nacidos.

Abstract | There are few case reports of hemolytic disease in fetuses and newborns (HDFN) caused by alloantibodies against the MNS blood group system. The reason for this dearth is that antibodies toward these antigens are usually IgM, which not only cannot cross the placental circulation but also react at temperatures below 37°C. They are, therefore, of minimal clinical importance. Nevertheless, cases have been reported in which the presence of anti-M IgG antibodies caused severe HDFN and even intrauterine death in the presence of maternal-fetal MNS incompatibility indicating that they could have a high clinical impact. The hemolytic pattern observed in these cases is similar to that caused by anti-Kell antibodies. Progressive anemia is mediated and developed through hematopoietic suppression inducing the destruction of bone marrow precursor cells with the resulting absence of reticulocytes in peripheral blood. This occurred in the case of a woman at 38.5 weeks of gestation who showed a discrepancy between direct and reverse blood type determination. A direct Coombs test was performed on the newborn's blood, which was positive in the absence of maternal-fetal ABO incompatibility. Further tests were performed and anti-M antibodies were found in the maternal serum screening. Our final diagnosis was largely due to discrepancy issues in maternal blood. Although anti-M antibodies do not usually play a significant role in HDFN, this case stresses the importance of identifying the presence of antibodies that can be crucial in preventing HDFN and lead to new recommendations for the screening and prompt treatment of hemolysis in newborns.

Grupos sanguíneos y SARS-CoV-2 en personal de salud de un solo centro / Blood groups and SARS-CoV-2 in health professionals from a single center

Introducción: la posibilidad de que el grupo sanguíneo (GS) predisponga a infección por SARS-CoV-2 es controversial. Objetivo: comparar prevalencia de GS, anti-IgG SARS-CoV-2 y síntomas más frecuentes, en personal de salud convaleciente frente a controles previo a la vacunación. Material y métodos: diseño transversal analítico de casos y controles, que incluyó personal de salud, de marzo a junio de 2020, confirmados con reaccion en cadena de la polimerasa (PCR-SARS-CoV-2) y controles negativos con PCR y anti-IgG-SARS-COV-2. Se les interrogó sobre los síntomas y se determinó el GS. Se empleó estadística descriptiva y análisis comparativo con chi cuadrada o prueba exacta de Fisher y t de Student o U de Mann-Whitney. Resultados: de 218 trabajadores, 102 (46.8%) fueron casos confirmados para SARS-CoV-2 (convalecientes) y 116 controles. La distribución de GS fue similar entre los casos y los controles y el GS-O+ fue el más frecuente (52.9%). El riesgo de infectarse de SARS-CoV-2 para el GS-O, comparado con GS-No-O mostró menor tendencia: razón de momios [RM] 0.725 (intervalo de confianza del 95% [IC 95%] 0.416-1.261; p = ns). El GS-A (28.4%) comparado con GS-No-A (71.6%) mostró tendencia de incremento del riesgo en GS-A, RM 1.523 (IC 95% 0.818-2.837, p = ns). La presencia de anticuerpos IgG de SARS-CoV-2 fue del 85% en el grupo de convalecientes. Conclusiones: la prevalencia de infectados fue proporcionalmente mayor para GS-A y menor para GS-O. Alrededor de 15% no desarrollaron anticuerpos de SARS-CoV-2 después de recuperarse de COVID-19.

Background: The possibility that the blood group (BG) predisposes to SARS-CoV-2 infection is controversial. Objective: To compare the prevalence of BG, anti-IgG SARS-CoV-2, and more frequent symptoms in convalescent health personnel vs controls prior to vaccination. Material and methods: Analytical cross-sectional design of cases and controls, which included health personnel, from March to June 2020, confirmed with (polymerase chain reaction) PCR-SARS-CoV-2 and negative controls with PCR and anti-IgG-SARS-CoV-2. Participants were questioned concerning symptoms and BG was determined. It was used descriptive statistics and comparative analysis with chi squared, Fisher's exact test, Student's t, and Mann Whitney's U tests. Results: Of 218 workers, 102 (46.8%) were confirmed cases for SARS-CoV-2 (convalescent) and 116 controls. The distribution of BG was similar between cases and controls, being BG-O + the most frequent (52.9%). The risk of becoming infected by SARS-CoV-2 for BG-O compared to BG-No-O showed a lower trend (odds ratio [OR] 0.725, 95% confidence interval [95% CI] 0.416-1.261, p = ns). The BG-A (28.4%) compared with BG-No-A (71.6%) showed a trend of increased risk in BG-A (OR 1.523, 95% CI 0.818-2.837, p = ns). The presence of SARS-CoV-2 IgG antibodies was 85% in the convalescent group. Conclusions: The prevalence of infected was proportionally higher for BG-A and lower for BG-O. About 15% did not develop SARS-CoV-2 antibodies after overcoming COVID-19 disease.

Características clínico-epidemiológicas de pacientes cubanos residentes en La Habana afectados por la COVID-19 / Clinical-epidemiological characteristics of patients affected by COVID-19 residing in Havana

Introducción: La Habana fue el territorio más complejo a nivel nacional en el enfrentamiento al primer brote de la COVID-19. Su condición de capital, la densidad poblacional, la escasa delimitación geográfica entre sus municipios, el elevado flujo intermunicipal e interprovincial de personas, sumado a que es la provincia que mayor número de viajeros recibe procedentes del extranjero, confirieron a este territorio particularidades en el enfrentamiento a la pandemia. Objetivo: Determinar las principales características clínico-epidemiológicas de pacientes cubanos residentes en La Habana afectados por la COVID-19. Métodos: Se realizó un estudio observacional, analítico, de corte transversal. La muestra quedó formada por 431 pacientes, mayores de un año, de alta epidemiológica de la infección por SARS-CoV-2. Para la recolección de información se aplicó un cuestionario a través de una entrevista. Resultados: La edad promedio de la muestra fue de 45 años. Más de la mitad de los casos evolucionaron de modo sintomático (no grave o grave). La fiebre fue la manifestación clínica más frecuente. Los individuos incluidos en la muestra, con grupo sanguíneo O, o con antecedentes de asma, mostraron menos riesgo de presentar formas sintomáticas de la enfermedad. Conclusiones: Los resultados sugieren que la edad constituye el principal factor de riesgo para desarrollar formas sintomáticas (no graves o graves) de la COVID-19. De modo contrario, el grupo sanguíneo O y el antecedente de asma son factores de protección para estas formas de evolución clínica(AU)

Introduction: Havana city was the most complex territory at the national level facingthe first outbreak of COVID-19. Its condition of capital, the population density, the limited geographical delimitation between its municipalities, the high inter-municipal and inter-provincial flow of people, added to the fact that it is the province that receives the largest number of travelers from abroad, conferred particularities on this territory. Objective: To determine the main clinical-epidemiological characteristics of patients affected by COVID-19 living in Havana. Methods: An observational, analytical, cross-sectional study was carried out. The sample contained 431 patients, older than one year, with epidemiological discharge from the SARS-CoV-2 infection. To collect information, a questionnaire was applied through an interview. Results: The average age of the sample was 45 years. More than half of the cases evolved in a symptomatic way (not serious or serious). Fever was the most frequent clinical manifestation. The individuals included in the sample, with blood group O or with a background of asthma, showed less risk of presenting symptomatic forms of the disease. Conclusions: The results suggest that age is the main risk factor for developing symptomatic forms (not severe or severe) of COVID-19. On the contrary, blood group O and a history of asthma are protective factors for these forms of clinical evolution(AU)