ABO blood types and SARS-CoV-2 infection assessed using seroprevalence data in a large population-based sample: the SAPRIS-SERO multi-cohort study.

ABO blood type has been reported as a potential factor influencing SARS-CoV-2 infection, but so far mostly in studies that involved small samples, selected population and/or used PCR test results. In contrast our study aimed to assess the association between ABO blood types and SARS-CoV-2 infection using seroprevalence data (independent of whether or not individuals had symptoms or sought for testing) in a large population-based sample. Our study included 67,340 French participants to the SAPRIS-SERO multi-cohort project. Anti-SARS-CoV-2 antibodies were detected using ELISA (targeting the proteins spike (S) and nucleocapsid (NP)) and seroneutralisation (SN) tests on dried blood spots collected in May-November 2020. Non-O individuals (and especially types A and AB) were more likely to bear anti SARS-CoV-2 antibodies (ELISA-S, 2964 positive cases: ORnon-Ovs.O = 1.09[1.01-1.17], ORAvs.O = 1.08[1.00-1.17]; ELISA-S/ELISA-NP/SN, 678 triple positive cases: ORnon-Ovs.O = 1.19 [1.02-1.39], ORAvs.O = 1.19[1.01-1.41], ORABvs.O = 1.43[1.01-2.03]). Hence, our results provided additional insights into the dynamic of SARS-CoV-2 infection, highlighting a higher susceptibility of infection for individuals of blood types A and AB and a lesser risk for blood type O.

ABO-Rh Blood Types and Clinical Consequences of COVID-19 Infection.

Aim and Background: Because of there is no sufficient evidence showing a relationship between blood types and severity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, this study was planned to investigate the effects of ABO blood group on the clinical outcomes of SARS-CoV-2 infection. Patients and Methods: The data of the patients were examined retrospectively. The patients who were hospitalized in wards or intensive care unit, constituted the study group. The patients who presented to the hospital because of other causes and whose blood type examinations were performed, were included in the control group. Results: The study group consisted of 406 six patients were diagnosed with SARS-CoV-2 infection. Control group consisted of 38079 patients whose blood group was determined for any reason in the same period. The rate of Rh negativity was significantly higher in the patient group (p = 0,01). Hospitalization duration in intensive care was significantly longer in the blood type A and AB groups compared to the blood type O group (p = 0,03). Conclusion: Our results are in agreement with other studies suggesting that blood group O individuals are somewhat more resistant to clinically overt infection with SARS-CoV-2 than other blood groups. In addition, Rh negativity may also be an individual risk factor for SARS-CoV-2 infection.

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

BACKGROUND AND OBJECTIVES: It 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 METHODS: A 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. RESULTS: In 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. CONCLUSION: There 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.

Systematic review and meta-analysis of the effect of ABO blood group on the risk of SARS-CoV-2 infection.

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).

Association between ABO blood group and COVID-19 infection: an updated systematic review and meta-analysis.

The relationship between ABO blood group and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 - coronavirus disease 19 [COVID-19]) infection has been investigated, and several studies have reported discordant findings. This systematic review and meta-analysis study were conducted to investigate the relationship between ABO blood group and COVID-19 infection. The international databases Institute for Scientific Information (ISI)/Web of Science, PubMed, and Scopus were systematically searched from 1 January 2020 through 14 June 2021. Twenty-seven studies met the inclusion criteria for meta-analysis including 23,285 COVID-19 case subjects and 590,593 control subjects. The odds of having each blood group among COVID-19 patients compared with control subjects were calculated. The random effects model was used to obtain the overall pooled odds ratio (OR). Publication bias and subgroup and sensitivity analyses were performed to explore the source of heterogeneity. According to the random effects model, the results indicated that the pooled estimates of OR (95% confidence interval) for blood groups A, O, B, and AB were 1.26 (1.13-1.40), 0.77 (0.71-0.82), 1.05 (0.99-1.12), and 1.11 (0.99-1.25), respectively. Therefore, individuals infected with COVID-19 have higher odds of having blood group A and lower odds of having blood group O. In conclusion, this study indicated that individuals with blood group A are more susceptible to COVID-19 infection, whereas those with blood group O are less susceptible to COVID-19 infection. However, further studies are warranted to support these findings.

Economic impact of a machine learning-based strategy for preparation of blood products in brain tumor surgery.

BACKGROUND: Globally, blood donation has been disturbed due to the pandemic. Consequently, the optimization of preoperative blood preparation should be a point of concern. Machine learning (ML) is one of the modern approaches that have been applied by physicians to help decision-making. The main objective of this study was to identify the cost differences of the ML-based strategy compared with other strategies in preoperative blood products preparation. A secondary objective was to compare the effectiveness indexes of blood products preparation among strategies. METHODS: The study utilized a retrospective cohort design conducted on brain tumor patients who had undergone surgery between January 2014 and December 2021. Overall data were divided into two cohorts. The first cohort was used for the development and deployment of the ML-based web application, while validation, comparison of the effectiveness indexes, and economic evaluation were performed using the second cohort. Therefore, the effectiveness indexes of blood preparation and cost difference were compared among the ML-based strategy, clinical trial-based strategy, and routine-based strategy. RESULTS: Over a 2-year period, the crossmatch to transfusion (C/T) ratio, transfusion probability (Tp), and transfusion index (Ti) of the ML-based strategy were 1.10, 57.0%, and 1.62, respectively, while the routine-based strategy had a C/T ratio of 4.67%, Tp of 27.9%%, and Ti of 0.79. The overall costs of blood products preparation among the ML-based strategy, clinical trial-based strategy, and routine-based strategy were 30, 061.56$, 57,313.92$, and 136,292.94$, respectively. From the cost difference between the ML-based strategy and routine-based strategy, we observed cost savings of 92,519.97$ (67.88%) for the 2-year period. CONCLUSION: The ML-based strategy is one of the most effective strategies to balance the unnecessary workloads at blood banks and reduce the cost of unnecessary blood products preparation from low C/T ratio as well as high Tp and Ti. Further studies should be performed to confirm the generalizability and applicability of the ML-based strategy.

Development and Validation of a Treatment Benefit Index to Identify Hospitalized Patients With COVID-19 Who May Benefit From Convalescent Plasma.

Importance: Identifying which patients with COVID-19 are likely to benefit from COVID-19 convalescent plasma (CCP) treatment may have a large public health impact. Objective: To develop an index for predicting the expected relative treatment benefit from CCP compared with treatment without CCP for patients hospitalized for COVID-19 using patients' baseline characteristics. Design, Setting, and Participants: This prognostic study used data from the COMPILE study, ie, a meta-analysis of pooled individual patient data from 8 randomized clinical trials (RCTs) evaluating CCP vs control in adults hospitalized for COVID-19 who were not receiving mechanical ventilation at randomization. A combination of baseline characteristics, termed the treatment benefit index (TBI), was developed based on 2287 patients in COMPILE using a proportional odds model, with baseline characteristics selected via cross-validation. The TBI was externally validated on 4 external data sets: the Expanded Access Program (1896 participants), a study conducted under Emergency Use Authorization (210 participants), and 2 RCTs (with 80 and 309 participants). Exposure: Receipt of CCP. Main Outcomes and Measures: World Health Organization (WHO) 11-point ordinal COVID-19 clinical status scale and 2 derivatives of it (ie, WHO score of 7-10, indicating mechanical ventilation to death, and WHO score of 10, indicating death) at day 14 and day 28 after randomization. Day 14 WHO 11-point ordinal scale was used as the primary outcome to develop the TBI. Results: A total of 2287 patients were included in the derivation cohort, with a mean (SD) age of 60.3 (15.2) years and 815 (35.6%) women. The TBI provided a continuous gradation of benefit, and, for clinical utility, it was operationalized into groups of expected large clinical benefit (B1; 629 participants in the derivation cohort [27.5%]), moderate benefit (B2; 953 [41.7%]), and potential harm or no benefit (B3; 705 [30.8%]). Patients with preexisting conditions (diabetes, cardiovascular and pulmonary diseases), with blood type A or AB, and at an early COVID-19 stage (low baseline WHO scores) were expected to benefit most, while those without preexisting conditions and at more advanced stages of COVID-19 could potentially be harmed. In the derivation cohort, odds ratios for worse outcome, where smaller odds ratios indicate larger benefit from CCP, were 0.69 (95% credible interval [CrI], 0.48-1.06) for B1, 0.82 (95% CrI, 0.61-1.11) for B2, and 1.58 (95% CrI, 1.14-2.17) for B3. Testing on 4 external datasets supported the validation of the derived TBIs. Conclusions and Relevance: The findings of this study suggest that the CCP TBI is a simple tool that can quantify the relative benefit from CCP treatment for an individual patient hospitalized with COVID-19 that can be used to guide treatment recommendations. The TBI precision medicine approach could be especially helpful in a pandemic.

ABO blood group and COVID-19: a review on behalf of the ISBT COVID-19 Working Group.

Growing evidence suggests that ABO blood group may play a role in the immunopathogenesis of SARS-CoV-2 infection, with group O individuals less likely to test positive and group A conferring a higher susceptibility to infection and propensity to severe disease. The level of evidence supporting an association between ABO type and SARS-CoV-2/COVID-19 ranges from small observational studies, to genome-wide-association-analyses and country-level meta-regression analyses. ABO blood group antigens are oligosaccharides expressed on red cells and other tissues (notably endothelium). There are several hypotheses to explain the differences in SARS-CoV-2 infection by ABO type. For example, anti-A and/or anti-B antibodies (e.g. present in group O individuals) could bind to corresponding antigens on the viral envelope and contribute to viral neutralization, thereby preventing target cell infection. The SARS-CoV-2 virus and SARS-CoV spike (S) proteins may be bound by anti-A isoagglutinins (e.g. present in group O and group B individuals), which may block interactions between virus and angiotensin-converting-enzyme-2-receptor, thereby preventing entry into lung epithelial cells. ABO type-associated variations in angiotensin-converting enzyme-1 activity and levels of von Willebrand factor (VWF) and factor VIII could also influence adverse outcomes, notably in group A individuals who express high VWF levels. In conclusion, group O may be associated with a lower risk of SARS-CoV-2 infection and group A may be associated with a higher risk of SARS-CoV-2 infection along with severe disease. However, prospective and mechanistic studies are needed to verify several of the proposed associations. Based on the strength of available studies, there are insufficient data for guiding policy in this regard.

Does blood type affect the COVID-19 infection pattern?

Among the many aspects that characterize the COVID-19 pandemic, two seem particularly challenging to understand: i) the great geographical differences in the degree of virus contagiousness and lethality that were found in the different phases of the epidemic progression, and, ii) the potential role of the infected people's blood type in both the virus infectivity and the progression of the disease. A recent hypothesis could shed some light on both aspects. Specifically, it has been proposed that, in the subject-to-subject transfer, SARS-CoV-2 conserves on its capsid the erythrocytes' antigens of the source subject. Thus these conserved antigens can potentially cause an immune reaction in a receiving subject that has previously acquired specific antibodies for the source subject antigens. This hypothesis implies a blood type-dependent infection rate. The strong geographical dependence of the blood type distribution could be, therefore, one of the factors at the origin of the observed heterogeneity in the epidemics spread. Here, we present an epidemiological deterministic model where the infection rules based on blood types are taken into account, and we compare our model outcomes with the exiting worldwide infection progression data. We found an overall good agreement, which strengthens the hypothesis that blood types do play a role in the COVID-19 infection.

Trans-ancestry analysis reveals genetic and nongenetic associations with COVID-19 susceptibility and severity.

COVID-19 presents with a wide range of severity, from asymptomatic in some individuals to fatal in others. Based on a study of 1,051,032 23andMe research participants, we report genetic and nongenetic associations with testing positive for SARS-CoV-2, respiratory symptoms and hospitalization. Using trans-ancestry genome-wide association studies, we identified a strong association between blood type and COVID-19 diagnosis, as well as a gene-rich locus on chromosome 3p21.31 that is more strongly associated with outcome severity. Hospitalization risk factors include advancing age, male sex, obesity, lower socioeconomic status, non-European ancestry and preexisting cardiometabolic conditions. While non-European ancestry was a significant risk factor for hospitalization after adjusting for sociodemographics and preexisting health conditions, we did not find evidence that these two primary genetic associations explain risk differences between populations for severe COVID-19 outcomes.

Association between ABO blood types and coronavirus disease 2019 (COVID-19), genetic associations, and underlying molecular mechanisms: a literature review of 23 studies.

An association of various blood types and the 2019 novel coronavirus disease (COVID-19) has been found in a number of publications. The aim of this literature review is to summarize key findings related to ABO blood types and COVID-19 infection rate, symptom presentation, and outcome. Summarized findings include associations between ABO blood type and higher infection susceptibility, intubation duration, and severe outcomes, including death. The literature suggests that blood type O may serve as a protective factor, as individuals with blood type O are found COVID-19 positive at far lower rates. This could suggest that blood type O individuals are less susceptible to infection, or that they are asymptomatic at higher rates and therefore do not seek out testing. We also discuss genetic associations and potential molecular mechanisms that drive the relationship between blood type and COVID-19. Studies have found a strong association between a locus on a specific gene cluster on chromosome three (chr3p21.31) and outcome severity, such as respiratory failure. Cellular models have suggested an explanation for blood type modulation of infection, evidencing that spike protein/Angiotensin-converting enzyme 2 (ACE2)-dependent adhesion to ACE2-expressing cell lines was specifically inhibited by monoclonal or natural human anti-A antibodies, so individuals with non-A blood types, specifically O, or B blood types, which produce anti-A antibodies, may be less susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to the inhibitory effects of anti-A antibodies.

The impact of COVID-19 on transfusion-dependent thalassemia patients of Karachi, Pakistan: A single-center experience.

OBJECTIVES: With the advent of COVID-19 in Pakistan, the already fragmented blood transfusion services (BTS) received a severe blow, putting the lives of transfusion-dependent thalassemia children on stake. This study aimed to assess the impact of the COVID-19 on blood transfusion therapy (BTT) of thalassemia patients and suggest ways to ensure safe and reliable blood supplies amid such health crises. MATERIAL AND METHODS: A retrospective, cross-sectional study was conducted from October 2019 (before COVID-19) to July 2020 (during COVID-19) based on the data provided by a thalassemia center, named Help International Welfare Trust, Karachi, Pakistan. SPSS version 24.0 was used for the data analysis. Data were described in the form of means and percentages. RESULTS: There was a significant reduction in the consumption of PRBCs bags after the emergence of COVID-19 (P=0.002). Moreover, the number of thalassemia patients receiving BTT was dropped by 10.56% during the pandemic. There was a strong negative correlation observed between the rising cases of COVID-19 in Pakistan and the number of patients missing their therapy sessions (r=-0.914, P=0.030). A considerable decline in the reserves of all Rhesus-negative blood groups amid the COVID-19 outbreak was also observed. CONCLUSION: The COVID-19 pandemic adversely affected the already suboptimal care catered to thalassemia patients in Karachi, Pakistan. The fear of the virus contraction coupled with the lockdown and restricted mobility has disrupted the entire transfusion chain from donor to the recipient. Collaborated efforts by the government and healthcare authorities are essential to ensure sufficient blood for thalassemia patients amid the pandemic.

The Impact of ABO Blood Grouping on COVID-19 Vulnerability and Seriousness: A Retrospective Cross-Sectional Controlled Study among the Arab Community.

Background and Objectives: Studies have noted that some ABO blood types are more susceptible to COVID-19 virus infection. This study aimed to further confirm the relationship between different blood groups on the vulnerability, symptoms, cure period, and severity among COVID-19 recovered patients. Subjects and Methods: This cross-sectional study approached the participants from the Arab community via social media (mainly Facebook and WhatsApp). The data were collected through two Google Form questionnaires, one for COVID-19 recovered patients (COVID-19 group, n = 726), and the other for the healthy people (Control group, n = 707). Results: The subjects with blood group O were the least likely to be infected with the COVID-19 virus, while those with blood group A were not likely to be the most susceptible. There were significant differences among different ABO blood groups regarding the distribution of oxygen saturation percentage, myalgia, and recovery time after COVID-19 infection (p < 0.01, 0.01, and 0.05, respectively). The blood group A showed the highest percentage of patients who experienced an oxygen saturation range of 90-100%, whereas the blood group O showed the highest percentage of patients who experienced an oxygen saturation range of 70-80%. The blood group A showed the lowest percentage of patients who required artificial respiration, whereas the blood group O showed the highest percentage of patients who required artificial respiration. The blood group B showed the lowest percentage of patients who experienced myalgia and exhibited the lowest percentage of patients who needed 3 weeks or more to recover. Conclusion: The people of blood group O may be the least likely to be infected with COVID-19, however, they may be the more in need of treatment in hospital and artificial respiration compared to the other blood groups.

Association Between ABO Blood Group System and COVID-19 Susceptibility in Wuhan.

Background: The ABO blood group system has been associated with multiple infectious diseases, including hepatitis B, dengue haemorrhagic fever and so on. Coronavirus disease 2019 (COVID-19) is a new respiratory infectious disease and the relationship between COVID-19 and ABO blood group system needs to be explored urgently. Methods: A hospital-based case-control study was conducted at Zhongnan Hospital of Wuhan University from 1 January 2020 to 5 March 2020. A total of 105 COVID-19 cases and 103 controls were included. The blood group frequency was tested with the chi-square statistic, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated between cases and controls. In addition, according to gender, the studied population was divided into two subgroups, and we assessed the association between cases and controls by gender. Finally, considering lymphopenia as a feature of COVID-19, the relationship between the ABO blood group and the lymphocyte count was determined in case samples. Results: The frequencies of blood types A, B, AB, and O were 42.8, 26.7, 8.57, and 21.9%, respectively, in the case group. Association analysis between the ABO blood group and COVID-19 indicated that there was a statistically significant difference for blood type A (P = 0.04, OR = 1.33, 95% CI = 1.02-1.73) but not for blood types B, AB or O (P = 0.48, OR = 0.90, 95% CI = 0.66-1.23; P = 0.61, OR = 0.88, 95% CI = 0.53-1.46; and P = 0.23, OR = 0.82, 95% CI = 0.58-1.15, respectively). An analysis stratified by gender revealed that the association was highly significant between blood type A in the female subgroup (P = 0.02, OR = 1.56, 95% CI = 1.08-2.27) but not in the male subgroup (P = 0.51, OR = 1.14, 95% CI = 0.78-1.67). The average level of lymphocyte count was the lowest with blood type A in patients, however, compared with other blood types, there was still no significant statistical difference. Conclusions: Our findings provide epidemiological evidence that females with blood type A are susceptible to COVID-19. However, these research results need to be validated in future studies.