Associations between blood type and COVID-19 infection, intubation, and death

Abstract

The rapid global spread of the novel coronavirus SARS-CoV-2 has strained healthcare and testing resources, making the identification and prioritization of individuals most at-risk a critical challenge. Recent evidence suggests blood type may affect risk of severe COVID-19. Here, we use observational healthcare data on 14,112 individuals tested for SARS-CoV-2 with known blood type in the New York Presbyterian (NYP) hospital system to assess the association between ABO and Rh blood types and infection, intubation, and death. We find slightly increased infection prevalence among non-O types. Risk of intubation was decreased among A and increased among AB and B types, compared with type O, while risk of death was increased for type AB and decreased for types A and B. We estimate Rh-negative blood type to have a protective effect for all three outcomes. Our results add to the growing body of evidence suggesting blood type may play a role in COVID-19.

Fig. 1. Estimated risk differences for blood types during the period from March 10 to August 1, 2020.

Values represent risk differences for each blood type relative to the reference groups: O for ABO and positive for Rh(D). Prevalence differences were computed using linear regression, while intubation and death were computed using the Fine-Gray model. Estimated differences are represented as points. 95% confidence intervals (CI, represented as bars) were computed using the Austin’s method with n = 1000 bootstrap iterations. Adjusted models include race and ethnicity as covariates.