Infectious Disease

Research contradict earlier findings on blood group and COVID-19 severity, mortality

January 08, 2021

4 min read

Source / information

Source:

Ramo et al. Abstract 104. Presented at: ASH Annual Meeting and Exposition (virtual meeting); December 5th to 8th, 2020.

Disclosure:
The researchers do not report any relevant financial information.

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Understanding the risk factors for the susceptibility and severity of COVID-19 was a constant goal of researchers during the pandemic.

The ABO blood group was a research focus. Studies have shown that people with blood type A are more likely to develop COVID-19 and have poor results.

Source: Adobe Stock.

However, two studies presented at the ASH virtual annual meeting and exhibition showed no significant association between blood type and the severity of COVID-19.

Classroom Ramo, MD

Classroom

“We found that ABO blood group and Rh factor are not related to mortality, disease severity, or mechanical ventilation use.” Branch, MD, A resident of the internal medicine department at Henry Ford Hospital said in an interview with Healio. “We also looked at predictors of mortality in part of our study and found that age 65 and over, Caucasian race, and male gender are statistically significant predictors of mortality.”

In another study presented at ASH, researchers at Rush University Medical Center wanted to determine whether patients with COVID-19 and certain blood types were at higher risk of thrombosis or higher mortality rates.

“There have been some early studies that suggested certain blood types are a predictor of being more susceptible to COVID-19,” said Rush researchers Shivani Rao said Healio. “After that, the next logical question is what can predispose the patient to greater severity of the disease. One of the things that we’ve seen a lot clinically is that thrombosis is often a marker of severity. So we wanted to investigate whether the blood type can predispose a patient to thrombosis. “

Other important factors

The Henry Ford Hospital study showed that demographic and clinical factors other than blood type appeared to be associated with COVID-19 severity.

For the study, Ramo and colleagues evaluated records of hospital patients with COVID-19 who were treated at the facility between March 10 and April 30. The analysis included 1,488 eligible patients (mean age 68 years; range 19-99; 54% women, 58% black) with various backgrounds. The researchers used univariate and multivariate logistic regression to analyze variables such as age, gender, race, ABO blood type, comorbid conditions, disease severity (based on ICU admission), and intubation as predictors of mortality, based on the survival data updated July 15.

About one third of the patients (32.6%; n = 485) had blood group A, while 276 (18.5%) had blood group B, 658 (44.2%) had blood group O and 69 (4.6%) had blood group AB .

Of the 469 patients (31.5%) who required admission to the intensive care unit, 370 were intubated. At the last follow-up examination, 411 patients (27.6%) had died.

The results showed no association between ABO blood groups and Rh factor and admission, intubation or death in the intensive care unit. A multivariate analysis, however, revealed significant associations of mortality with age 65 or older (OR = 4.27; 95% CI, 3.19-5.71), the male sex (OR = 1.57; 95% CI , 1.23-2.01) and the white race (OR) = 1.46; 95% CI, 1.14-1.86) and chronic obstructive pulmonary disease (OR = 1.49; 95% CI, 1.09-2.04).

The researchers found that black patients were almost 40% less likely to die than white patients (OR = 0.56; 95% CI, 0.44-0.7).

Ramo said while the severity of COVID-19 can be influenced by socioeconomic circumstances, these factors are difficult to quantify. She said the definition of “disease severity” has evolved over time.

“Intensive care unit admission, which serves as an indicator of disease severity, has really changed since the pandemic began,” she said. “It continues to vary based on availability and hospital workflow.”

Thrombosis and COVID-19

For the retrospective study, conducted at Rush University Medical Center, researchers reviewed the records of 1,265 patients with COVID-19 who were treated at the facility between March 1 and June 26.

The analysis included 138 patients with imaging-confirmed thromboembolism. A total of 102 patients with thrombosis and 402 without thrombosis had known blood types that were used in the analysis.

The researchers found no significant differences in blood group prevalence in patients with COVID-19 compared to the general population without COVID-19 (type A, 34.3% versus 32.7%; type AB, 2.9% versus 4.2%; Type B, 16.7)% versus 14.9%; Type O 46.1% versus 48.1%). Similarly, the results showed no significant difference between blood groups in terms of the incidence of thrombosis (type A, 23.3%; type AB, 15%: type B, 20.7%; type O, 18.7%) or the Mortality (type A, 20.7%; type AB) 15%; Type B 13.4%; Type O 21.8%).

Regarding the different results of her blood type study compared to previous reports, Rao said her study was limited by the small sample size.

“We started with more than 1,000 patients who were COVID-19 positive at our facility between March and June. We only had about a hundred patients who had reported blood types and had thrombosis, ”she said. “That’s a very small percentage of what we originally started with. I think in future studies we want to look at a larger population of patients with thrombosis. “

Co-author of the study, Shivi Jain, MD, The assistant professor of internal medicine in the Department of Hematology and Director of Diagnostic Bone Marrow Services at Rush University Medical Center also noted that patients with COVID-19 and thrombosis are generally sicker.

“In order to determine the blood type, you would have to have a threshold for serious illness,” she said. “This may have skewed the way we collected data, as only a small number of the original 1,000 or so patients reported blood types.”

Rao said the study reflects an overall effort to learn more about the factors associated with the severity of COVID-19.

“That’s exactly why we wanted to conduct this study. The risk factors for COVID-19 are somewhat known, but we think it is very important to also study other factors such as blood type that influence the severity of COVID-19, “she said.

References:

Ramo et al. Abstract 104. Presented at: ASH Annual Meeting and Exposition (virtual meeting); December 5th to 8th, 2020.
Rao et al. Abstract 244. Presented at: ASH Annual Meeting and Exposition (virtual meeting); December 5th to 8th, 2020.

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ASH annual conference and exhibition

ASH annual conference and exhibition

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