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Soares DMB, Araújo DABS, de Souza JLDB, Maurício RB, Soares EMB, Neto FDCA, Pinheiro MSN, Gama VCDV, Braga-Neto P, Nóbrega PR, Aragão GF. Correlation between ABO blood type, susceptibility to SARS-CoV-2 infection and COVID-19 disease severity: A systematic review. Hematol Transfus Cell Ther 2023; 45:483-494. [PMID: 36467112 PMCID: PMC9708632 DOI: 10.1016/j.htct.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/07/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES To verify the association between the ABO blood type and the risk of SARS-CoV-2 infection and COVID-19 disease severity. METHODS This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using the 2020 PRISMA Checklist and flow diagram, and articles selected for review were analyzed using the Newcastle-Ottawa Quality Rating Scale. The research question was: "Would the ABO blood group influence the risk of infection and clinical course of patients infected with SARS-CoV-2?", The following databases were used: Embase, PubMed, Virtual Health Library (VHL), Web of Science, ScienceDirect and Scopus. The protocol for this review was registered in the Prospective Register of Systematic Reviews (PROSPERO), number CRD42021245945. RESULTS We found 798 articles across PubMed, Embase, Scopus, Web of Science, Science Direct and Virtual Health Library and 54 articles were included in the final analysis. Among 30 studies evaluating the risk of COVID-19 infection, 21 found significant correlations with ABO blood groups, 14 of them revealing an increased risk in blood group A and 15 studies showing a decreased risk in blood group O. Most studies found no significant correlation with disease severity or mortality. CONCLUSION The qualitative assessment of available information suggests that blood group A may be a risk factor for COVID-19 infection and that blood group O may have a protective effect. We were unable to determine a clear association between the ABO blood group and mortality. These conclusions are based on highly heterogenous evidence.
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Pereira E, Felipe S, de Freitas R, Araújo V, Soares P, Ribeiro J, Henrique Dos Santos L, Alves JO, Canabrava N, van Tilburg M, Guedes MI, Ceccatto V. ABO blood group and link to COVID-19: A comprehensive review of the reported associations and their possible underlying mechanisms. Microb Pathog 2022; 169:105658. [PMID: 35764188 PMCID: PMC9233352 DOI: 10.1016/j.micpath.2022.105658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/20/2022]
Abstract
ABO blood group is long known to be an influencing factor for the susceptibility to infectious diseases, and many studies have been describing associations between ABO blood types and COVID-19 infection and severity, with conflicting findings. This narrative review aims to summarize the literature regarding associations between the ABO blood group and COVID-19. Blood type O is mostly associated with lower rates of SARS-CoV-2 infection, while blood type A is frequently described as a risk factor. Although results regarding the risk of severe outcomes are more variable, blood type A is the most associated with COVID-19 severity and mortality, while many studies describe O blood type as a protective factor for the disease progression. Furthermore, genetic associations with both the risk of infection and disease severity have been reported for the ABO locus. Some underlying mechanisms have been hypothesized to explain the reported associations, with incipient experimental data. Three major hypotheses emerge: SARS-CoV-2 could carry ABO(H)-like structures in its envelope glycoproteins and would be asymmetrically transmitted due to a protective effect of the ABO antibodies, ABH antigens could facilitate SARS-CoV-2 interaction with the host’ cells, and the association of non-O blood types with higher risks of thromboembolic events could confer COVID-19 patients with blood type O a lower risk of severe outcomes. The hypothesized mechanisms would affect distinct aspects of the COVID-19 natural history, with distinct potential implications to the disease transmission and its management.
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Affiliation(s)
- Eric Pereira
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil.
| | - Stela Felipe
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Raquel de Freitas
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Valdevane Araújo
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Paula Soares
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Jannison Ribeiro
- Hematology and Hemotherapy Center of Ceará, José Bastos Av., Fortaleza, 60431-086, Ceará, Brazil
| | - Luiz Henrique Dos Santos
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Juliana Osório Alves
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Natália Canabrava
- Biotechnology and Molecular Biology Laboratory, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Mauricio van Tilburg
- Biotechnology and Molecular Biology Laboratory, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Maria Izabel Guedes
- Biotechnology and Molecular Biology Laboratory, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
| | - Vânia Ceccatto
- Superior Institute of Biomedical Sciences, State University of Ceará, Dr. Silas Munguba Av., Fortaleza, 60714-903, Ceará, Brazil
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