The potential use of ABO blood group system for risk stratification of COVID-19

Abstract

ABO blood groups is a cheap and affordable test that can be immediately retrieved from COVID-19 patients at the diagnosis. There is increasing evidence that non-O blood groups have both higher susceptibility and higher severity of COVID-19 infections. The reason behind such relationship seems elusive. Regarding susceptibility, Non-O individuals have Anti-A antibodies which can prevent viral entry across ACE-2 receptors, moreover, Non-O individuals are at higher risk of autoimmunity, hypercoagulable state, and dysbiosis resulting in an augmented tendency for vascular inflammatory sequelae of COVID-19. We can conclude, on the diagnostic level, that ABO blood groups can be potentially used for risk stratification of affected COVID-19 patients, to anticipate the deterioration of patients at higher risk for complications. On a therapeutic level, plasma from normal O blood group individuals might potentially replace the use of convalescent serum for the treatment of COVID-19.

Keywords: ABO blood group; COVID-19; Hypercoagulability; Immune dysregulation; Microbiota; Obesity.

Fig. 1

ABO blood group relationship to susceptibility and severity of COVID-19. Abbreviations: ACE2: Angiotensin Converting Enzyme 2, BMI: Body Mass Index, COVID-19 (Coronavirus disease 2019).