COVID-19 and blood groups: A six-months observational study in Ferrara, Italy

Abstract

The current literature still gives a little information about the relationships between the ABO blood group system and the immune response to the virus or the different disease outcomes. Hypothesizing the presence of a predisposition by some blood groups to COVID-19, we searched for differences between patients towards the different outcomes of disease.We enrolled 330 inpatients with a diagnosis of COVID-19, determining both their ABO blood group system and Rh factor, collecting demographic, clinical and laboratory data. We searched for relationships with COVID-19 outcomes within an observation period of 180 days (Intensification of Care - IoC, Inhospital death, 180-days mortality). The most frequent ABO blood group was A (45.8%); a minor part was represented by group O (38.8%), B (11.5%), AB (3.9%). As for the Rh factor, 86.7% of patients were Rh-positive. There were no significant differences between blood groups and Rh factors as for age, length of hospital stays (LoS), or Charlson Comorbidity Index (CCI), nor we found significant relationships between the ABO groups and COVID-19 outcomes. A significant relation was found between AB group and IoC (p=0.03) while as for the Rh factor, the patients with Rh factor positive died with less frequency during the stay (p=0.03). Cox regression analyses showed substantial differences in the survival functions concerning the Rh factors. The Rh factor seems to be involved in the 180-day prognosis. The survival functions of patients with Rh factor positive show, in fact, significantly better curves when compared to those with Rh factor negative.

Keywords: ABO; COVID-19; Coronavirus; Rh factor; blood group.

Figure 1.

Box a: Cox regression analysis, survival at the 180^th day since the first positive viral RNA detection in the four populations (Group O=blue curve; Group A= red curve; Group B= orange curve; Group AB= green curve). Box b: Cox regression analysis, survival at the 180^th day since the first positive viral RNA detection in the four populations (Group O=blue curve; Group A= red curve; Group B= orange curve; Group AB= green curve) adjusted for age and CCI (Charlson Comorbidity Index).

Figure 2.

Box a: Cox regression analysis, survival at the 180^th day since the first positive viral RNA detection in the two populations (Rh neg= blue curve; Rh pos= red curve). Box b: Cox regression analysis, survival at the 180^th day since the first positive viral RNA detection in the two populations (Rh neg= blue curve; Rh pos= red curve) adjusted for age and CCI (Charlson Comorbidity Index).