The Impact of ABO Blood Group on Clinical Outcomes and Susceptibility in COVID-19: A Retrospective Population Study of 3305 Patients
Notice bibliographique
Résumé
Background: Factors determining inherent susceptibility to infection with the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and the risk of severe outcomes in infected individuals remain poorly understood. Landsteiner ABO blood groups have been linked to host susceptibility to various infections through the interaction of the carbohydrate moieties defining ABO antigens with micro-organisms and the immune system. Previous studies of the original SARS coronavirus (SARS-CoV-1) demonstrated a decreased susceptibility to infection in group O individuals (Cheng et al. JAMA 2005; 293:1450-1) and the ability of plasma-derived anti-A antibodies to block the interaction between viral spike protein and human angiotensin-converting enzyme 2 receptor in vitro (Guillon et al. Glycobiology 2008; 18:1085-93). A recent genome-wide association study of patients with respiratory failure complicating coronavirus disease 2019 (COVID-19) suggested a higher risk of severe disease in group A, and a protective effect in group O (Ellinghaus et al. NEJM 2020 DOI:10.1056/NEJMoa2020283). Since the inception of the COVID-19 pandemic, a broad testing strategy was implemented in Kuwait and all individuals testing positive for SARS-CoV-2 were admitted to a single facility, including asymptomatic individuals. Here we examined the clinical outcomes of this cohort with respect to ABO blood group and compared its blood group distribution to that of the general population. Methods: All patients testing positive for SARS-CoV-2 by polymerase chain reaction assay of a nasopharyngeal swab specimen that were admitted to Jaber Hospital between February 24th to May 27th 2020 were included in the study. Relevant demographic and clinical data were extracted from hospital records. An anonymized summary of the distribution of blood types of the entire population of Kuwait was obtained from a national database and used as a control group. Clinical outcomes were in accordance with international consensus definitions. Appropriate statistical tests were used for bivariate analysis. Multivariate logistic regression was performed to determine relationships between variables of interest and outcome. Results: Of 3305 SARS-CoV-2 positive patients 37.1%, 25.5%, 28.9% and 8.5% were group O, A, B and AB respectively. 69.2% were male and 30.8% were female. Median age was 42 years. 48.1% were Kuwaiti citizens and 51.9% were non-Kuwaiti. Commonest comorbidities were hypertension (21.5%) and diabetes (20.1%). 17.4% were obese. 37.2% were asymptomatic on admission. There was no significant difference in baseline characteristics among the blood groups. Univariate analysis of clinical outcomes revealed no significant differences in need for oxygen support, admission to intensive care, intubation or death among the blood groups. However, rates of any adverse event and pneumonia differed significantly (Table 1). Multivariable analysis adjusted for age, sex, obesity and comorbidities showed that group A had higher odds of developing pneumonia compared to the other blood groups combined (adjusted odds ratio 1.32, 95% confidence interval 1.02-1.72, p<0.0363). We found no relationship between pneumonia and other blood groups. Compared to the general population, the COVID-19 cohort had a lower frequency of group O, equivalent frequency of group A and higher frequency of groups B and AB (Table 2). This trend was independent of nationality (Kuwaiti versus non-Kuwaiti). Incorporation of Rh (D) status did not impact the trend observed with ABO blood groups. Finally, no significant difference in Rh (D) status was found between the COVID-19 and general populations (Rh positive 93.4% versus 93.6% respectively, p=0.99) Conclusion: In a large, unselected patient population, no association between blood group and severe clinical outcomes in COVID-19 was found. Consistent with reports in other populations, we found a lower prevalence of blood group O in SARS-CoV-2 positive individuals and higher prevalence of blood group B and AB implicating a potential role of ABO blood group in susceptibility to infection. No association between SARS-CoV-2 infection with blood group A or Rh (D) group was found. Further examination of the mechanistic link between ABO antigens, antibodies and SARS-CoV-2, and its implications on controlling the current pandemic is warranted. Disclosures No relevant conflicts of interest to declare.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».