ABO blood types as a risk factor for severe symptoms of COVID-19 infection
DOI:
https://doi.org/10.12923/Keywords:
ABO blood group, blood phenotype, SARS-CoV-2 infection, COVID-19Abstract
Numerous studies have investigated whether the ABO blood group system influences susceptibility to SARS-CoV-2 infection and disease severity. The association between blood type and COVID-19 is thought to involve both genetic and environmental factors. The present study aimed to evaluate the relationship between ABO blood phenotypes and the severity of COVID-19 among Arab populations, with a particular focus on Iraqi patients.
To assess the association between ABO blood phenotypes and the occurrence
and severity of SARS-CoV-2 infection.
A total of 731 patients with COVID-19 confirmed by a positive PCR test were included in the study. A control group consisted of healthy volunteers with negative PCR results and no clinical symptoms of COVID-19. In all participants, ABO blood phenotype was determined. In infected patients, disease severity and mortality were evaluated and analyzed in relation to blood group phenotype.
Patients with blood group A demonstrated a higher risk of COVID-19 infection compared with non-A blood groups. In contrast, individuals with blood group O showed a significantly lower incidence of COVID-19 infection and reduced disease severity (odds ratio [OR] = 0.686; 95% confidence interval [CI]: 0.521-0.902). No statistically significant differences were observed for other blood groups. Among critically ill patients, blood group A was associated with a significantly higher mortality rate compared with non-A blood groups (OR = 3.341; 95% CI: 1.416-8.158).
Blood group A is associated with an increased risk of severe COVID-19 manifestations, including pneumonia and mortality, whereas blood group O appears to confer a protective effect against severe disease.
References
1. Alzobaidy MA, Alburghaif AH, Alhasany HA, Naji MA. Angiotensin-converting enzyme inhibitors may increase risk of severe COVID-19 infection. Ann Rom Soc Cell Biol. 2021;25(6):17843-17849.
2. Worldwide COVID-19 cases surpass 500 million as Omicron subvariant BA.2 surges. CBC News. 2022 Apr 14. Available from: https://www.cbc.ca/news/health/worldwide-covid-cases-1.6419773
3. Al-Kuraishy HM, Al-Gareeb AI, Al-Hussaniy HA, et al. Neutrophil extracellular traps (NETs) and COVID-19: a new frontier for therapeutic modalities. Int Immunopharmacol. 2022;104:108516. https://doi.org/10.1016/j.intimp.2021.108516
4. Mostafa-Hedeab G, Al-Kuraishy HM, Al-Gareeb AI, et al. A rising dawn of pentoxifylline in the management of inflammatory disorders in COVID-19. Inflammopharmacology. 2022;29:1-11. https://doi.org/10.1007/s10787-021-00893-1
5. Wang Y, Wang Y, Chen Y, et al. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 2020;92(6):568-576. https://doi.org/10.1002/jmv.25748
6. Al-Kuraishy HM, Al-Gareeb AI, Al-Hussaniy HA. Doxorubicin-induced cardiotoxicity: molecular mechanisms and protection by conventional drugs and natural products. Int J Clin Oncol Cancer Res. 2017;2(2):31-44.
7. Kabrah SM, Kabrah AM, Flemban AF, Abuzerr S. Susceptibility of ABO blood group to COVID-19 infections: clinico-hematological, radiological, and complications analysis. Medicine (Baltimore). 2021;100(52):e28334. https://doi.org/10.1097/MD.0000000000028334
8. Chrysanthakopoulos NA. Examination of the relationship between the ABO blood group and susceptibility to SARS-CoV-2 infection risk. Insights Blood Disord. 2022;1(1):1-11.
9. Tomas M, Capanoglu E, Bahrami A, et al. The direct and indirect effects of bioactive compounds against coronavirus. Food Front. 2022;3(1):96-123. https://doi.org/10.1002/fft2.115
10. Al-Hussaniy HA, Alburghaif AH, Naji MA. Leptin hormone and its effectiveness in reproduction, metabolism, immunity, diabetes, hopes, and ambitions. J Med Life. 2021;14(5):600-605. https://doi.org/10.25122/jml-2021-0140
11. Al-Kuraishy HM, Al-Gareeb AI, Naji HA. Febuxostat modulates oxidative and apoptotic pathways in acute doxorubicin-induced cardiotoxicity: an experimental animal model study. Asian J Pharm Clin Res. 2019;12(4):73-76. https://doi.org/10.22159/ajpcr.2019.v12i4.31402
12. Valenti L, Villa S, Baselli G, et al. Association of ABO blood group and secretor phenotype with severe COVID-19. Transfusion. 2020;60(12):3067-3070. https://doi.org/10.1111/trf.16003
13. Aschenbrenner AC, Mouktaroudi M, Krämer B, et al. Disease severity-specific neutrophil signatures in blood transcriptomes stratify COVID-19 patients. Genome Med. 2021;13(1):7. https://doi.org/10.1186/s13073-020-00823-5
14. Zietz M, Zucker J, Tatonetti NP. Associations between blood type and COVID-19 infection, intubation, and death. Nat Commun. 2020;11:5761. https://doi.org/10.1038/s41467-020-19623-x
15. AbdelMassih AF, Mahrous R, Taha A, Saud A. The potential use of ABO blood group system for risk stratification of COVID-19. Med Hypotheses. 2020;145:110343. https://doi.org/10.1016/j.mehy.2020.110343
16. Meylan S, Akrour R, Regina J, et al. An early warning score to predict ICU admission in COVID-19 positive patients. J Infect. 2020;81(5):816-846. https://doi.org/10.1016/j.jinf.2020.08.047
17. Chowdhury F, Grigoriadou S, Bombardieri M. Severity of COVID-19 infection in primary Sjögren’s syndrome and emerging evidence of COVID-19-induced xerostomia. Clin Exp Rheumatol. 2021;39(Suppl 133):S215-S222.
18. Cheng Y, Cheng G, Chui CH, et al. ABO blood group and susceptibility to severe acute respiratory syndrome. JAMA. 2005;293(12):1447-1451. https://doi.org/10.1001/jama.293.12.1447
19. Ahmad T, Shah MW, Ahmad H, Khan M. Coronavirus disease 2019 (COVID-19): perspective of Pakistan. J Pure Appl Microbiol. 2020;14(Suppl 1):699-702. https://doi.org/10.22207/JPAM.14.SPL1.58
20. Lehrer S, Rheinstein PH. ABO blood groups, COVID-19 infection and mortality. Blood Cells Mol Dis. 2021;89:102571. https://doi.org/10.1016/j.bcmd.2021.102571
21. Badedi M, Alnami A, Darraj H, et al. Clinical characteristics and ABO blood groups in COVID-19 patients, Saudi Arabia. Medicine (Baltimore). 2021;100(30):e26738. https://doi.org/10.1097/MD.0000000000026738
22. Liu N, Zhang T, Ma L, et al. The impact of ABO blood group on COVID-19 infection risk and mortality: a systematic review and meta-analysis. Blood Rev. 2021;48:100785. https://doi.org/10.1016/j.blre.2020.100785
23. Almadhi MA, Abdulrahman A, Alawadhi A, et al. The effect of ABO blood group and antibody class on the risk of COVID-19 infection and severity of clinical outcomes. Sci Rep. 2021;11:5745. https://doi.org/10.1038/s41598-021-84810-9
24. Datta PK, Liu F, Fischer T, Rappaport J, Qin X. SARS-CoV-2 pandemic and research gaps: understanding SARS-CoV-2 interaction with the ACE2 receptor and implications for therapy. Theranostics. 2020;10(16):7448-7464. https://doi.org/10.7150/thno.48076
25. Al-Hussaniy HA, Altalebi RR, Alburagheef A, Abdul-Amir AG. The use of PCR for respiratory virus detection in the diagnosis and treatment decision of respiratory tract infections in Iraq. J Pure Appl Microbiol. 2022;16(1):201-206. https://doi.org/10.22207/JPAM.16.1.14
26. Cava C, Bertoli G, Castiglioni I. In silico discovery of candidate drugs against COVID-19. Viruses. 2020;12(4):404. https://doi.org/10.3390/v12040404
27. Al-Hussaniy HA, Al-Tameemi ZS, Al-Zobaidy MJ. In silico comparison between mutated and wild-type androgen receptors and their influence on the selection of optimum androgen receptor blockers for prostate cancer treatment. F1000Res. 2022;11:516. https://doi.org/10.12688/f1000research.110072.1
28. Al-Kuraishy HM, Al-Gareeb AI, Alblihed M, et al. COVID-19 and risk of acute ischemic stroke and acute lung injury in patients with type II diabetes mellitus: the anti-inflammatory role of metformin. Front Med (Lausanne). 2021;8:644295. https://doi.org/10.3389/fmed.2021.644295
29. Shareef LG, Al-Hussainy AF, Hameed SM. COVID-19 vaccination hesitancy among the Iraqi general population: beliefs and barriers. F1000Res. 2022;11:545. https://doi.org/10.12688/f1000research.110545.2
30. Choudhury A, Mukherjee S. In silico studies on the comparative characterization of the interactions of SARS-CoV-2 spike glycoprotein with ACE2 receptor homologs and human TLRs. J Med Virol. 2020;92(10):2105-2113. https://doi.org/10.1002/jmv.25987
31. Moubarak M, Kasozi KI, Hetta HF, et al. The rise of SARS-CoV-2 variants and the role of convalescent plasma therapy for management of infections. Life (Basel). 2021;11(8):734. https://doi.org/10.3390/life11080734
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