Role of ABO Blood Group in SARS-CoV-2 Infection in Households

Abstract

An association between certain ABO/Rh blood groups and susceptibility to SARS-CoV-2 infection has been proposed for adults, although this remains controversial. In children and adolescents, the relationship is unclear due to a lack of robust data. Here, we investigated the association of ABO/Rh blood groups and SARS-CoV-2 in a multi-center study comprising 163 households with 281 children and 355 adults and at least one SARS-CoV-2 seropositive individual as determined by three independent assays as a proxy for previous infection. In line with previous findings, we found a higher frequency of blood group A (+ 6%) and a lower frequency of blood group O (-6%) among the SARS-CoV-2 seropositive adults compared to the seronegative ones. This trend was not seen in children. In contrast, SARS-CoV-2 seropositive children had a significantly lower frequency of Rh-positive blood groups. ABO compatibility did not seem to play a role in SARS-CoV-2 transmission within the families. A correction for family clusters was performed and estimated fixed effects of the blood group on the risk of SARS-CoV-2 seropositivity and symptomatic infection were determined. Although we found a different distribution of blood groups in seropositive individuals compared to the reference population, the risk of SARS-CoV-2 seropositivity or symptomatic infection was not increased in children or in adults with blood group A or AB versus O or B. Increasing age was the only parameter positively correlating with the risk of SARS-CoV-2 infection. In conclusion, specific ABO/Rh blood groups and ABO compatibility appear not to predispose for SARS-CoV-2 susceptibility in children.

Keywords: ABO blood group; COVID-19; SARS-CoV-2; children; household transmission.

FIGURE 1

Overall observed blood group type distribution in children and adults (A) and frequency of SARS-CoV-2 transmission from index case to exposed individuals (n = 357) within the household cohort according to ABO blood group compatibility (B). (A) Blood group prevalence in child and adult household members and in a German reference population (20). Numbers next to the columns represent the proportion of the particular blood group within the subject group (in percent). Rh, rhesus factor. (B) The black bar indicates the proportion of SARS-CoV-2 seropositive individuals, and the white bar indicates the proportion of SARS-CoV-2 seronegative individuals.