Association of ABO blood group with COVID-19

Introduction and Purpose: The Covid-19 pandemic that started with the reporting of pneumonia cases of unknown etiology in the city of Wuhan, China, on December 2019, massively changed the lifestyle and caused a large number of deaths, continues to have an impact all over the world. The first Covid-19 case in our country was detected on March 2020, and the number of cases has increased in our country as well as all over the world. Findings related to the factors affecting the severity of Covid-19 and the contagion of SARS-Cov-2 continue to be added to the literature. No relationship has yet been established between susceptibility to Covid-19 disease and any biomarker. Differences in the expression of blood group antigens may affect host susceptibility to infections, and blood groups may directly induce infection as a receptor or coreceptor. This study also aims to determine the association of the ABO blood group with Covid-19. Materials and Methods: This study was created by the retrospective evaluation of patients who applied to Bezmialem Vakıf University Hospital between 01.03.2020 - 30.06.2020 and were diagnosed with "definite Covid-19" by PCR test. Patients' age, gender, blood groups, laboratory findings, Thorax CT findings, accompanying chronic diseases, and clinical course during hospitalization were examined, and recorded low saturation, high fever, need for ICU, and survival after treatment were examined. A control group was formed based on a study conducted with 136,231 people in 2020, which is thought to represent the blood group distribution of the province of Istanbul. The relationship of blood groups with Covid-19 disease was examined and its statistical significance was researched. Statistical analyzes were performed using "IBM® SPSS© 24" software. Man Whitney U, Chi-square tests, Kruskal-Wallis Test, One-Way Analysis of Variance and Binary Logistic Regression Analysis were used while evaluating the study data. Significance was evaluated at the level of p<0.05. Findings: As a result of the comparison of the blood group distribution of the individuals included in the study with the reference values, a statistically significant difference was detected (p<0.05), and blood group A was the most frequently observed group among individuals with Covid-19, while blood group AB was the least. In our study, 6% of individuals with blood group O required need for ICU, and it was determined that the risk of ICU need at least among blood groups was in blood group O. In addition, in the O/NonO comparison according to ICU hospitalization, it was determined that the blood group O required less need for ICU and this difference xvii was statistically significant (p<0.05). Although no difference was found in the comparison of blood groups (A, B, AB, O) according to low saturation, a statistically significant difference was discovered between O/NonO groups (p<0.05). We observed lower saturation in blood group O. We did not detect a statistically significant difference in the effects of ABO blood groups (with reference to A blood group) on ICU hospitalization and discharge/death (p>0.05) according to Binary Logistic Regression Analysis. Conclusion: While additional studies are needed to reveal the role of ABO blood groups in SARS-Cov-2 contagiousness and Covid-19 disease severity, cumulative evidence suggests that ABO blood groups can be used as a marker to determine the contagiousness among Covid-19 patients and to show the severity of the disease. However, we consider that the effects of chronic diseases, personal factors such as age, timely access to appropriate medical care and behavioral changes that play a role in contagion are more dominant in the course of Covid-19, and ABO blood groups play a secondary role. The relationship between ABO blood groups and Covid-19 can be a guide in determining the strategies in vaccination, which is one of the most basic applications of preventive medicine, but this relationship needs to be clarified with more comprehensive studies. Keywords: Covid-19 Disease, SARS-CoV-2, ABO Blood Groups