Sex and ABO Blood Differences in SARS-CoV-2 Infection Susceptibility

Abstract

Data consisting of millions of cases cannot still explain the immunopathogenesis mechanism between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and host cell for ongoing coronavirus disease 2019 (COVID-19) pandemics. Epidemiological studies among different populations suggested different impacts of ABO and Rh antibodies on the COVID-19 susceptibility. Thus, the ABO blood group and the SARS-CoV-2 infection paradox remain unclear. Therefore, the present retrospective case-control study aimed to investigate the possible association between ABO blood groups and Rh blood types on SARS-CoV-2 infection in the Turkish Cypriot population. A total of 18,639 Turkish Cypriot subjects (297 SARS-CoV-2 COVID-19 patients and 18,342 healthy) were included in this study. Personal and clinical characteristics including age, gender, SARS-CoV-2 infection status, the ABO blood group and Rh blood types were evaluated and compared between two groups. As a result, ABO blood group was shown to be associated with a higher risk of SARS-CoV-2 infection as well as with male sex (p = 0.018). There was no association between Rh blood type and COVID-19. Overall, this study is the first largest sample group study to show the distribution of ABO blood group and Rh blood types in the healthy Turkish Cypriot population. Based on the current evidence, there are insufficient data to guide public health policies regarding COVID-19 pathogenesis.

Keywords

ABO blood group / Rh blood type / SARS-CoV-2 / COVID-19 / Turkish Cypriot

References

[1] Grant MC, Geoghegan L, Arbyn M, et al. The prevalence of symptoms in 24,410 adults infected by the novel coronavirus (SARS-CoV-2; COVID-19): a systematic review and meta-analysis of 148 studies from9 countries. PLoS One 2020;15(06):e0234765

[2] Ellinghaus D, Degenhardt F, Bujanda L, et al; Severe Covid-19 GWAS Group. Genomewide association study of severe Covid-19 with respiratory failure. N Engl J Med 2020;383(16):1522-1534

[3] Benetti E, Tita R, Spiga O, et al; GEN-COVID Multicenter Study. ACE2 gene variants may underlie interindividual variability and susceptibility to COVID-19 in the Italian population. Eur J Hum Genet 2020;28(11):1602-1614

[4] Novelli A, Biancolella M, Borgiani P, et al. Analysis of ACE2 genetic variants in 131 Italian SARS-CoV-2-positive patients. Hum Genomics 2020;14(01):29

[5] Iyer GR, Samajder S, Zubeda S, et al. Infectivity and progression of COVID-19 based on selected host candidate gene variants. Front Genet 2020;11:861

[6] Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020;181(02):271-280.e8

[7] Paniri A, Hosseini MM, Akhavan-Niaki H. First comprehensive computational analysis of functional consequences of TMPRSS2 SNPs in susceptibility to SARS-CoV-2 among different populations. J Biomol Struct Dyn 2021;39(10):3576-3593

[8] Butler-Laporte G, Nakanishi T, Mooser V, et al. Vitamin D levels and COVID-19 susceptibility: is there any correlation? PLoS Med 2021;18(06):e1003605

[9] Razdan K, Singh K, Singh D. Levels and COVID-19 susceptibility: is there any correlation? Med Drug Discov 2020;7:100051

[10] Butler MJ, Barrientos RM. The impact of nutrition on COVID-19 susceptibility and long-term consequences. Brain Behav Immun 2020;87:53-54

[11] Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497-506

[12] Cooling L. Blood groups in infection and host susceptibility. Clin Microbiol Rev 2015;28(03):801-870

[13] Cheng Y, Cheng G, Chui CH, et al. ABO blood group and susceptibility to severe acute respiratory syndrome. JAMA 2005;293(12): 1450-1451

[14] Guillon P, Clément M, Sébille V, et al. Inhibition of the interaction between the SARS-CoV spike protein and its cellular receptor by antihisto- blood group antibodies. Glycobiology 2008;18(12):1085-1093

[15] Fan Q, Zhang W, Li B, Li DJ, Zhang J, Zhao F. Association between ABO blood group system and COVID-19 susceptibility in Wuhan. Front Cell Infect Microbiol 2020;10:404

[16] Li J, Wang X, Chen J, Cai Y, Deng A, Yang M. Association between ABO blood groups and risk of SARS-CoV-2 pneumonia. Br J Haematol 2020;190(01):24-27

[17] WHO COVID-19 Dashboard. Geneva:World Health Organization, 2020. (Accessed date: 16May 2022). Available at: https://covid19.who.int/

[18] Gündüz M, Temel H. The relationship between the distribution of ABO and Rh blood groups and the clinical course in children with COVID-19. ADYÜ Sağlık Bilimleri Derg 2021;7(01):32-37

[19] Behera B, Rout B, Panigrahy R, et al. ABO bloodgrouping and COVID- 19: a hospital-based study in Eastern India. Egyptian JMed Human Genetics 2022;23(07):1-6. Doi: 10.1186/s43042-022-00225-9

[20] Rana R, Ranjan V, Kumar N. Association of ABO and Rh blood group in susceptibility, severity, and mortality of coronavirus disease 2019: a hospital-based study from Delhi, India. Front Cell Infect Microbiol 2021;11:767771

[21] Kerbage A, Haddad SF, Nasr L, et al. Impact of ABO and Rhesus blood groups on COVID-19 susceptibility and severity: a casecontrol study. J Med Virol 2022;94(03):1162-1166

[22] Solmaz İ, Araç S ABO blood groups in COVID-19 patients; crosssectional study. Int J Clin Pract 2021;75(04):e13927

[23] Dal MS, Ata N, Altuntaş F, et al. COVID-19 clinical course and blood groups: Turkish population-based study. Turk J Med Sci 2021;51(04):1659-1664

[24] Latz CA, DeCarlo C, Boitano L, et al. Blood type and outcomes in patients with COVID-19. Ann Hematol 2020;99(09): 2113-2118

[25] 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

[26] Vahidy FS, Pan AP, Ahnstedt H, et al. Sex differences in susceptibility, severity, and outcomes of coronavirus disease 2019: crosssectional analysis from a diverse US metropolitan area. PLoS One 2021;16(01):e0245556

[27] He W, Liu X, Feng L, et al. Impact of SARS-CoV-2 on male reproductive health: a review of the literature on male reproductive involvement in COVID-19. Front Med (Lausanne) 2020; 7:594364

[28] Jin JM, Bai P, He W, et al. Gender differences in patients with COVID-19: focus on severity and mortality. Front Public Health 2020;8:152

[29] Goel R, Bloch EM, Pirenne F, et al; ISBT COVID-19Working Group. ABO blood group and COVID-19: a review on behalf of the ISBT COVID-19 Working Group. Vox Sang 2021;116(08):849-861

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