Infección por SARS-CoV-2 y grupos sanguíneos en pacientes cubanos diagnosticados con la COVID-19

Introducción: Diferentes estudios han propuesto la relación entre los grupos sanguíneos del sistema ABO y la susceptibilidad a la COVID-19 y su importancia en el curso de la enfermedad. Objetivo: Determinar la frecuencia fenotípica de grupos sanguíneos ABO y RhD en un grupo de pacientes con infección activa por SARS-CoV-2. Métodos: Se realizó un estudio descriptivo, transversal y caso control en el Hospital Docente Clínico Quirúrgico "Freyre Andrade" de La Habana, para determinar la frecuencia fenotípica ABO y RhD en un grupo de pacientes con enfermedad activa por la COVID-19. Se estudiaron 928 muestras de sangre de pacientes con diagnóstico de COVID-19 y 1050 muestras pertenecientes a individuos sanos como grupo control. El grupo sanguíneo ABO y RhD se determinó por método de aglutinación en tubo con sueros hemoclasificadores anti-A, anti-B, anti-A+B, yanti-D. Los resultados fueron expresados en frecuencias absolutas y relativas y se determinó la asociación del grupo sanguíneo con la gravedad de la enfermedad por medio de la prueba no paramétrica de χ2 con un nivel de significación de p ≤ 0,05. Resultados: Se observó predominio del fenotipo O (49,24 %) seguido del A (35,79 %), B (12,68 %) y AB (2,27 %) respectivamente. Los fenotipos O y B presentaron significación estadística para la ocurrencia de la COVID-19, con valores de p < 0,05. No se encontró significación estadística en cuanto al predominio de un fenotipo particular y la necesidad de cuidados intensivos. Conclusiones: La relación del grupo sanguíneo ABO en la infectividad por SARS-CoV-2 y la gravedad de la enfermedad por la COVID-19 requiere estudios adicionales ya que los actuales no son concluyentes.

Introduction: Different studies have proposed the relationship between the blood groups of ABO system and the susceptibility to COVID-19 and its importance in the course of the disease. Objective: To determine the phenotypic frequency of ABO and RhD blood groups in a group of patients with active SARS-CoV-2 infection. Methods: A descriptive, cross-sectional, case-control study was conducted to determine the ABO and RhD phenotypic frequency in a group of patients with COVID-19 active disease. Nine hundred twenty eight blood samples and 1050 samples belonging to healthy individuals as control group were studied. The ABO and RhD blood group was determined by the tube agglutination method with anti-A, anti-B, anti-A+B, and anti-D blood classifying sera. The results were expressed in absolute and relative frequencies and the association of the blood group with the severity of the disease was determined by the non-parametric χ2 test with a significance level of p ≤ 0.05. Results: A predominance of phenotype O (49.24%) was observed, followed by A (35.79%), B (12.68%) and AB (2.27%) respectively. The O and B phenotypes showed statistical significance for the occurrence of COVID-19, with p values < 0.05. No statistical significance was found regarding the prevalence of a particular phenotype and the need for intensive care. Conclusions: The relationship of the ABO blood group in the infectivity of SARS-CoV-2 and the severity of the disease by COVID-19 requires additional studies, since the current ones are not conclusive.

Identification of pregnant women with DFR genotype and discussion of prenatal examination strategy / 中国输血杂志

【Objective】 To identify three cases of pregnant women with the D variant phenotype using serological and molecular tests, and discuss the strategy of prenatal examination. 【Methods】 The peripheral blood samples from three pregnant women with the D variant phenotype were collected. RhD variant phenotype was determined using routine serological methods with two different kinds of monoclonal anti-D. The serological characteristic for the epitope of D antigen was further analyzed using the commercial panel anti-D reagents (D-Screen, Diagast). The hybrid RHD-CE-D allele was analyzed by the Multiplex Ligation-dependent Probe Amplification (MLPA) assay and polymerase chain reaction with sequence specific primers (PCR-SSP) method. Further Sanger sequencing of RHD gene exons was also performed. 【Results】 DFR phenotype was primarily determined by serological characteristic for the epitope of D antigen. RHD*DFR2/01N.01(n=2) and RHD*DFR1/1227A(n=1) genotypes were identified by the MLPA assay, PCR-SSP and Sanger sequencing. 【Conclusion】 Two pregnant women with RHD*DFR2/01N.01 genotype should be treated as D negative patients clinically, while the pregnant woman with RHD*DFR1/1227A genotype can be treated as Asia type DEL to avoid unnecessary antibody screening and anti-D prophylaxis.

Correlation between irregular antibody profiles of non-Rh blood group system and incidence of hemolytic disease of the newborn, 53 cases / 中国输血杂志

【Objective】 To retrospectively analyze the irregular antibodies in 6 blood group systems other than the Rh blood group system in 53 pregnant women and analyze its correlation with the occurrence of hemolytic disease of the newborn(HDN). 【Methods】 19 473 pregnant women were screened for irregular antibodies by microgel detection technology combined with anti-human globulin (IgG+ C3d), and the positive samples screened out were further confirmed to understand the types and titers of irregular antibodies. Irregular antibody type determination experiment: IgG type irregular antibody titer was determined after mercaptoethanol (2-Me) inactivated the serum of the irregular antibody positive specimen, and then IgG and IgM type were determined by comparing the titer levels of irregular antibody. Three hemolysis tests and total bilirubin tests were performed on umbilical cord blood during delivery to analyze the level of jaundice and the occurrence of HDN. 【Results】 53 cases of irregular antibodies other than the Rh blood group system were detected in 19 473 pregnant women, with a positive rate of 0.27%, mainly MNS and Lewis blood group system.The incidence of HDN was 39.6% (21/53). There were 27 cases of IgM, 7 IgG, and 19 IgM + IgG. Comparison of total bilirubin detection between the low titer group (≤8) and the high titer group (>8) : the latter was significantly higher than the former (P<0.05); IgG antibody subtypes: IgG1 of the latter significantly increased (P<0.05), and so was IgG3 in former (P<0.05). There was a significant positive correlation between IgG1, IgG3 and total bilirubin. The area under the curve of IgG1+ IgG3 for HDN diagnosis, the sensitivity and specificity were 0.953, 0.900, and 0.967, respectively. 【Conclusion】 Other than Rh blood group system, irregular antibodies are mainly distributed in MNS and Lewis blood group system. The incidence of HDN is higher in Kell, Duffy and Kidd blood group systems after producing irregular antibodies. Non-antibody types are mostly IgM type or IgM + IgG mixed, and the incidence of HDN is not high; Patients with poor maternal history, either high or low titer, can be classified into IgG1 and IgG3 in early stages, and those with Abnormal results should be included into the perinatal management of high-risk women with regular checking.

Preliminary study on the safety of liver transplantation recipients with Rh blood group mismatching / 中华器官移植杂志

Objective To explore the safety of liver transplantation recipients with Rh blood group mismatchming .Methods From May 2005 to December 2018 ,1546 cases of liver transplantation in our hospital were retrospectively analyzed . Among these cases ,5 cases of Rh blood group mismatched were Rh(-) recipients receiving Rh(+ ) donor liver .For each Rh blood group mismatched liver transplantation ,5 patients received the same Rh blood group liver allograft were matched according to a certain principle and were defined as Rh-mismatch group and Rh-match group respectively .The serum alanine aminotransferase (ALT ) ,aspartate aminotransferase (AST ) and creatinine(SCr)were compared between two groups at Days 7 & 14 post-operation .Serum total bilirubin(TB) ,gamma-glutamyl transpeptidase(GGT)were compared between two groups at Month 1 , 6 & 12 post-operation .Hemoglobin (Hb)were compared between two groups Month 1 ,3 & 6 post-operation . The rates of infection ,vascular complications and acute rejection was also compared . Indirect antiglobulin test (IAT)was used for detecting the production of anti-RhD antibody in patients in Rh-mismatch group at Month 1 ,6 & 12 post-operation .Results At the mentioned time ,no significant inter-group difference existed in serum ALT ,AST ,SCr ,TB ,GGT and blood Hb levels (all P>0 .05);Also ,no significant difference existed in the incidence of infection ,vascular complications or acute rejection(all P> 0 .05) .In Rhmismatch group ,4 recipients received Rh (+ )RBC transfusion during perioperative period and no hemolytic anemia occurred after operation .Rh(D) antibody was negative at all timepoints .Conclusions Taking into account the rarity of Rh-negative blood group in Chinese ,it is safe and feasible to carry out Rh blood group mismatched liver transplantation when donor or recipient with the same Rh blood group is not available .

Preliminary study on the safety of liver transplantation recipients with Rh blood group mismatching / 中华器官移植杂志

Objective@#To explore the safety of liver transplantation recipients with Rh blood group mismatchming.@*Methods@#From May 2005 to December 2018, 1 546 cases of liver transplantation in our hospital were retrospectively analyzed. Among these cases, 5 cases of Rh blood group mismatched were Rh(-) recipients receiving Rh(+ ) donor liver. For each Rh blood group mismatched liver transplantation, 5 patients received the same Rh blood group liver allograft were matched according to a certain principle and were defined as Rh-mismatch group and Rh-match group respectively. The serum alanine aminotransferase (ALT), aspartate aminotransferase(AST)and creatinine(SCr)were compared between two groups at Days 7 & 14 post-operation. Serum total bilirubin(TB), gamma-glutamyl transpeptidase(GGT)were compared between two groups at Month 1, 6 & 12 post-operation. Hemoglobin (Hb)were compared between two groups Month 1, 3 & 6 post-operation. The rates of infection, vascular complications and acute rejection was also compared. Indirect antiglobulin test (IAT)was used for detecting the production of anti-RhD antibody in patients in Rh-mismatch group at Month 1, 6 & 12 post-operation.@*Results@#At the mentioned time, no significant inter-group difference existed in serum ALT, AST, SCr, TB, GGT and blood Hb levels(all P>0.05); Also, no significant difference existed in the incidence of infection, vascular complications or acute rejection(all P>0.05). In Rhmismatch group, 4 recipients received Rh(+ )RBC transfusion during perioperative period and no hemolytic anemia occurred after operation. Rh(D) antibody was negative at all timepoints.@*Conclusions@#Taking into account the rarity of Rh-negative blood group in Chinese, it is safe and feasible to carry out Rh blood group mismatched liver transplantation when donor or recipient with the same Rh blood group is not available.

Comparison of ABO and Rh-D Blood Group Systems between the Garo Tribal People of Mymensingh and General People of Dhaka City.

Background: The distribution pattern of ABO and Rh-D blood group in our country including the tribal people is not fully established as elaborated and large scale studies have not been carried out on it. Therefore this study was designed to observe the distribution pattern of ABO and Rh-D blood groups among the Garo tribes of Mymensingh and general people of Dhaka city. Objectives: To determine and to compare the distribution pattern of ABO and Rh-D blood groups among the Garo tribal people of Mymensingh and general people of Dhaka city and to compare this distribution between this two groups. Materials and Methods: This observational study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2008 to June 2009. After proper ethical consideration total 900 Garo people of Mymensingh and 784 general people of Dhaka city were included in this study. The Garo localities and the general people of Dhaka city were selected by systematic random sampling. ABO and Rh-D blood groups were determined by the antigen antibody agglutination test of slide method. Chi square statistical analyses were done to compare the results of ABO blood group systems between the Garo people and general people of Dhaka city. Results: This study revealed that there are significant variations in the distribution of ABO and Rh-D blood groups between the Garo tribal people of Mymensingh and the general people of Dhaka city. In this study it was observed that blood group ‘A’ was apparently predominant in Garo population, while blood group ‘B’ was predominant in general population (p<0.001), blood group ‘AB’ and ‘O’ were almost similar in both groups. Rh typing of the participants reveals that majorities of both groups were Rh positive. Rh negative persons are rare in both populations, but it is extremely rare in the Garo population (0.9%). Conclusion: From the findings of the present study it can be concluded that distribution of ABO and Rh-D blood groups varies between the Garo tribal people and the general people of Dhaka city.

Investigation of the distribution of Rh blood group in voluntary blood donors in Foshan,Guangdong province,China / 中国免疫学杂志

Objective:To investigate and analysis the distribution situations of Rh blood group system from voluntary blood donors in Foshan area.Methods:Anti-D,anti-C,anti-c,anti-E and anti-e reagents were used to identify Rh blood group system and the RhD(-) was confirmed.The phenotypes,haplotypes and corresponding genotypes frequencies were calculated and the datas were analyzed based on Hardy-Weinberg law.Results:The characteristics of phenotype frequencies in the voluntary blood donors in Foshan area was CCDee＞CcDEe＞CcDee＞ccDEE＞ccDEe＞CCDEe＞CcDEE＞ccdee＞ccDee,Ccdee＞CCdee,ccdEe＞CCDEE,CCdEE,CCdEe,CcdEE,CcdEe and ccdEE.The characteristics of haplotypes frequencies was CDe＞cDE＞cDe＞CDE,de＞Cde＞cdE＞CdE.The characteristics of genes frequencies was D＞d,C＞c,e＞E.The frequency of RhD(-)phenotype was 0.379%.The gene frequency of d was 0.061.The observed value and desired value of the haplotypes and corresponding genotypes were not statistically significant(P>0.05).The data were analyzed well based on Hardy-Weinberg law.Conclusion:The result is reliable according to Hardy-Weinberg law.The distribution of Rh blood group system from voluntary blood donors in Foshan area has geographic and general characteristics.The result is important in guiding the recruitment of voluntary blood donors and banking blood reasonably and enhancing the abilitiy of offering blood for the recipients of rare blood group.

Study of RHD genes among RhD negative individuals in Hainan province,China / 中国输血杂志

Objective To understand the RHD gene profiles of RhD negative individuals in Hainan Han population,and provide reference to establish the right method for RHD genotyping.Methods RhD was tested by anti-globulin test, and RhDel and genuine RhD-negative phenotype were identified by absorption/elution method. RhD negative samples were further tested for RHD exons by PCR-SSP.The RhD negative samples with intact RHD genes were further analyzed by PCR-SSP for RHD introns 2, 10 and RHD?gene. Results Thirty-one (29.25%)cases of RhDel individuals were identified among 106 apparent RhD-negative individuals. All RhDel samples had RHD genes;67 cases of genuine RhD-negative had no RHD genes and 8 cases were partial D. All 31 RhDel samples had Din2 and Din10 but none had RHD?. Additionally, We detected exons 1,3,4,6,7,9 and 10 in one case of ccdEe sample. Conclusion The proportion of RhDel phenotype is high among apparent RhD-negative Hainanese, and total RHD exons can be detected in all RhDel samples. Polymorphisms of RHD gene are present among genuine RhD-negative Hainanese. There is no exon 5 in all 8 cases of partial D, which suggests that exon 5 specific amplification may be very important in RHD genotyping for Hainan Han population.