The Relationship of ABO and Rh Blood Group Antigens with Mortality in Clinical and Intensive Care Patients with a Diagnosis of COVID-19: A Pandemic Hospital Experience

Yıl 2023, , 7 - 14, 31.03.2023

Serra Topal , Gülbahar Çalışkan , Ayça Sayan , Nermin Kelebek Girgin

https://doi.org/10.34087/cbusbed.1128848

Öz

Objective: Coronavirus 2019(COVID-19) has caused a pandemic that affects many people all over the world with high mortality.ABO blood groups are associated with many chronic diseases such as vascular and coronary heart diseases,as well as viral infections.In this study,we aimed to investigate the relationship of blood groups with susceptibility to COVID-19 and mortality.
Materials and Methods: Between 17 March 2020 and 30 November 2020,the files of adult patients that were hospitalized with the diagnosis of PCR positive COVID-19 in our hospital were reviewed retrospectively.Demographic data,distribution rates of ABO and Rh blood groups were recorded.The effect of blood groups on mortality was analyzed.The patients were grouped according to the presence of anti-A(B and O blood groups)or absence(A and AB blood groups) in their serum and compared in terms of age,gender,intensive care unit(ICU)admission, and mortality.
Results: 3137 patients were included in the study.Of the patients,2231 were hospitalized in the wards and 906 in the ICU.The patients were median 57 years old,51.2% of them were male.Most of ICU patients were male gender(p<0.001).The rates of having A,B,AB, and O blood groups of the patients were respectively 47.5%,14.5%,8.3%, and 29.6%.Treatment of 530 patients resulted in death.Age affected mortality in clinical and ICU patients(p= 0.000 for both).While male gender mortality(61.9%) was significantly higher in all patients(p<0.001).The presence of Rh and anti-A isohemagglutinin in the serum was'nt associated with mortality(p=0.42,p= 0.565).As a result of multivariate logistic regression analysis, blood group wasn't found to be associated with mortality. Age, male gender, and need for mechanical ventilation were found to be independent risk factors for mortality(Respectively.1.073 p=<0.001,OR.1.580 p=0.001,OR.40.061p<0.001).
Conclusion: In our study,no difference was found in the ABO blood group distributions of the patients followed both clinic and in the ICU.Mortality was higher in the AB blood group.Future studies are needed to show the relationship between ABO blood groups and SARS-CoV-2 infection.

Anahtar Kelimeler

ABO blood group, Rh blood group, COVID-19, mortality

COVID-19 Tanılı Klinik ve Yoğun Bakım Hastalarında ABO ve Rh Kan Grup Antijenlerinin Mortalite ile İlişkisi: Bir Pandemi Hastanesi Deneyimi

Öz

Giriş ve Amaç: Coronovirus 2019 (COVID-19) tüm dünyada pek çok kişiyi etkileyen ve mortalitesi yüksek olan pandemiye neden olmuştur. ABO kan grupları vasküler, koroner kalp hastalıkları gibi birçok kronik hastalık yanında viral enfeksiyonlarla da ilişkilendirilmektedir.Bu çalışmada kan gruplarının COVID-19’a yatkınlık ve mortalite ile ilşkisini araştırmayı amaçladık.
Gereç ve Yöntemler: 17 Mart 2020 ve 30 Kasım 2020 tarihleri arasında PCR pozitif COVID-19 tanısı ile hastanemizde yatırılarak tedavi edilen erişkin hastaların dosyaları retrospektif olarak incelendi. Demografik veriler, ABO ve Rh kan gruplarının dağılım oranları kaydedildi. Kan gruplarının mortaliteye etkisi incelendi. Hastalar serumlarında anti-A bulunması (B ve O kan grubu) ve bulunmamasına (A ve AB kan grubu) göre gruplandırılarak yaş, cinsiyet, yoğun bakıma (YB) yatış ve mortalite açısından karşılaştırıldı.
Bulgular: Çalışmaya 3137 hasta dahil edildi. Hastaların 2231’i kliniğe, 906’sı YB’ye yatırılmıştı. Hastalar 55.17±17.90 yaşında olup, %51.2’si erkek idi. Hastaların A, B, AB ve O kan grubuna sahip olma oranları sırasıyla %47.5, %14.5, %8.3 ve %29.6 idi. Hastaların 530’nun tedavisi eksitus ile sonuçlanmıştı. Yaş, klinik ve YB hastalarında mortaliteyi etkilemişti (ikisi için p=0.000). Tüm hastalarda erkek cinsiyette mortalite (%61.9) anlamlı olarak yüksekti (p=0.000). Rh’ın ve serumda anti-A izohemaglütinin bulunmasının mortalite ile ilişkisi yoktu (p=0.42, p=0.565). Multivariate lojistik regresyon analizi sonucu kan grubu mortalite ile ilişkili tespit edilmedi. Yaş, erkek cinsiyet ve mekanik ventilasyon gereksinimi mortalite için bağımsız risk faktörü olarak saptandı (sırasıyla OR.1.073p=<0.001, OR.1.580p=0.001, OR.40.061p<0.001).
Sonuç: Çalışmamızda hem klinik hem YB’de takip edilen hastaların ABO kan grubu dağılımlarında fark saptanmadı. Mortalite, AB kan grubunda yüksekti. ABO kan grupları ile SARS-CoV-2 enfeksiyonu arasındaki ilişkinin gösterilmesi için gelecek çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

ABO kan grubu, Rh kan grubu, COVID-19, mortalite

Kaynakça

• 1.Tsang HF, Chan LWC, Cho WCS, et al. An update on COVID-19 pandemic: the epidemiology, pathogenesis, prevention and treatment strategies. Expert Rev Anti Infect Ther 2021;19(7):877-88.
• 2.Latz CA, DeCarlo C, Boitano L, et al. Blood type and outcomes in patients with COVID-19. Ann Hematol 2020;99(9):2113-18.
• 3.Vasan SK, Rostgaard K, Majeed A, et al. ABO Blood Group and Risk of Thromboembolic and Arterial Disease: A Study of 1.5 Million Blood Donors. Circulation 2016;133(15):1449-57.
• 4.Solmaz İ, Araç S. ABO blood groups in COVID-19 patients; Cross-sectional study. Int J Clin Pract 2021;75(4).
• 5.Hosoi E. Biological and clinical aspects of ABO blood group system. J Med Invest 2008 Aug;55(3-4):174-82.
• 6.Cheng Y, Cheng G, Chui CH, et al. ABO blood group and susceptibility to severe acute respiratory syndrome. JAMA 2005;293(12):1450-1.
• 7.Zhao J, Yang Y, Huang H, et al. Relationship between the ABO Blood Group and the COVID-19 Susceptibility. Clin Infect Dis 2021;73(2):328-31.
• 8.Göker H, Aladağ Karakulak E, Demiroğlu H, et al. The effects of blood group types on the risk of COVID-19 infection and its clinical outcome. Turk J Med Sci 2020;50(4):679-83.
• 9.Yaylacı S, Dheir H, İşsever K, et al. The effect of abo and rh blood group antigens on admission to intensive care unit and mortality in patients with COVID-19 infection. Rev Assoc Med Bras 2020;66Suppl 2:86-90.
• 10. Gérard C, Maggipinto G, Minon JM. COVID-19 and ABO blood group: another viewpoint. Br J Haematol 2020 Jul;190(2):e93-e94
• 11. Bursa Uludağ Üniversitesi Kan Merkezi, 2019-2020 yılı yayınlanmamış kan grubu verileri.
• 12. Heper Y, Yılmaz E, Akalın H, Türe O. Bursa bölgesinde kan gruplarını dağılımı. 1.Ulusal Kan Merkezleri ve Transfüzyon Tıbbı Kongresi 24-29 Eylül 2000, Kapadokya.
• 13. Jing W, Zhao S, Liu J, Liu M. ABO blood groups and hepatitis B virus infection: a systematic review and metaanalysis. BMJ Open 2020;10:e034114.
• 14. He M, Wolpin B, Rexrode K, et al. ABO blood group and risk of coronary heart disease in two prospective cohort studies.Arterioscler Thromb Vasc Biol 2012;32(9):2314-20.
• 15. Cooling L. Blood Groups in Infection and Host Susceptibility. Clin Microbiol Rev 2015 Jul;28(3):801-70.
• 16. Deleers M, Breiman A, Daubie V, et al. Covid-19 and blood groups: ABO antibody levels may also matter. Int J Infect Dis 2021;104:242-49.
• 17. Abdollahi A, Mahmoudi-Aliabadi M, Mehrtash V, Jafarzadeh B, Salehi M. The Novel Coronavirus SARS-CoV-2 Vulnerability Association with ABO/Rh Blood Types. Iran J Pathol 2020;15(3):156-60.
• 18. Mathew A, Vignesh Balaji E, Pai SRK, Kishore A, Pai V, Chandrashekar KS. ABO phenotype and SARS-CoV-2 infection: Is there any correlation? Infect Genet Evol 2021;90:104751.
• 19. Mahmud R, Rassel MA, Monayem FB, et al. Association of ABO blood groups with presentation and outcomes of confirmed SARS CoV-2 infection: A prospective study in the largest COVID-19 dedicated hospital in Bangladesh. PLoS One 2021;16(4):e0249252.
• 20. Wu BB, Gu DZ, Yu JN, Yang J, Shen WQ. Association between ABO blood groups and COVID-19 infection, severity and demise: A systematic review and meta-analysis. Infect Genet Evol 2020;84:104485.
• 21. Rahim F, Amin S, Bahadur S, Noor M, Mahmood A, Gul H. ABO / Rh-D Blood types and susceptibility to Corona Virus Disease-19 in Peshawar, Pakistan. Pak J Med Sci 2021;37(1):4-8.
• 22. Türkiye İstatistik Kurumu.İstatistik Veri Portalı. Available from :https://data.tuik.gov.tr/ Kategori/ GetKategori?p=Nufus-ve-Demografi- 109 / Available date:17/01/2022.
• 23. Zietz M, Zucker J, Tatonetti NP. Associations between blood type and COVID-19 infection, intubation, and death. Nat Commun 2020;11(1):5761.