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. 2021 Mar:104:242-249.
doi: 10.1016/j.ijid.2020.12.025. Epub 2020 Dec 14.

Covid-19 and blood groups: ABO antibody levels may also matter

Marie Deleers  1 , Adrien Breiman  2 , Valéry Daubie  3 , Carine Maggetto  4 , Isabelle Barreau  5 , Tatiana Besse  6 , Béatrice Clémenceau  2 , Nathalie Ruvoën-Clouet  7 , Jean-François Fils  8 , Evelyne Maillart  9 , Virginie Doyen  10 , Bhavna Mahadeb  11 , Jacques C Jani  12 , Philippe Van der Linden  13 , Mieke M Cannie  14 , Nabil Hayef  15 , Francis Corazza  16 , Jacques Le Pendu  17 , Hanane El Kenz  5
Affiliations

Covid-19 and blood groups: ABO antibody levels may also matter

Marie Deleers et al. Int J Infect Dis. 2021 Mar.

Abstract

Background: Susceptibility to Covid-19 has been found to be associated with the ABO blood group, with O type individuals being at a lower risk. However, the underlying mechanism has not been elucidated. Here, we aimed to test the hypothesis that Covid-19 patients might have lower levels of ABO antibodies than non-infected individuals as they could offer some degree of protection.

Methods: After showing that the viral spike protein harbors the ABO glycan epitopes when produced by cells expressing the relevant glycosyltransferases, like upper respiratory tract epithelial cells, we enrolled 290 patients with Covid-19 and 276 asymptomatic controls to compare their levels of natural ABO blood group antibodies.

Results: We found significantly lower IgM anti-A + anti-B agglutination scores in blood group O patients (76.93 vs 88.29, P-value = 0.034) and lower levels of anti-B (24.93 vs 30.40, P-value = 0.028) and anti-A antibodies (28.56 vs 36.50, P-value = 0.048) in blood group A and blood group B patients, respectively, compared to controls.

Conclusion: In this study, we showed that ABO antibody levels are significantly lower in Covid-19 patients compared to controls. These findings could indicate that patients with low levels of ABO antibodies are at higher risk of being infected.

Keywords: ABO antibodies; ABO antibody levels; ABO blood group; Covid-19; Covid-19 infection risk.

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Figures

Figure 1
Figure 1
The SARS-CoV-2 S protein can be decorated with blood group antigens. (A) Surface expression of A, B and H antigens on HEK-293T cells, CHO-PDR2 (CHO), CHO-PDR2-FTB (CHO-H), CHO-PDR2-FTB + PBK-enzA (CHO-A) and CHO-PDR2-FTB + PBK-enzB (CHO-B) determined by flow cytometry. Percentage of positive cells is indicated on each histogram (MFI: mean fluorescence intensity). (B) Detection of A, B and H antigens on the S1-Fc protein produced in glycosyltransferases transfected CHO cells lines by ELISA. The S1-Fc protein expression in the 4 CHO cell lines was evaluated by using an anti-S protein. The results are expressed as -fold increase in the OD values relative to the mock transfected cells (background). For detection of A, B or H antigens, results are expressed as the ratio of the OD values obtained with the S1-Fc fusion protein produced in CHO-H, CHO-A and CHO-B cell lines to the OD values obtained with the S1-Fc fusion protein produced in CHO cell lines (controls). Mean and standard deviations of 3 independent experiments are shown.
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