Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan;63(1):47-58.
doi: 10.1111/trf.17170. Epub 2022 Nov 3.

A large cohort study of the effects of Lewis, ABO, 13 other blood groups, and secretor status on COVID-19 susceptibility, severity, and long COVID-19

Camous Moslemi  1 , Susanne Saekmose  1 , Rune Larsen  1 , Thorsten Brodersen  1 , Maria Didriksen  2 , Henrik Hjalgrim  3 , Karina Banasik  4 , Kaspar R Nielsen  5 , Mie T Bruun  6 , Joseph Dowsett  2 , Kathrine A Kasperen  7   8 , Susan Mikkelsen  7 , Thomas F Hansen  4   9 , Henrik Ullum  10 , Christian Erikstrup  7 , Martin L Olsson  11   12 , Sisse R Ostrowski  2   13 , Ole B Pedersen  1   13
Affiliations

A large cohort study of the effects of Lewis, ABO, 13 other blood groups, and secretor status on COVID-19 susceptibility, severity, and long COVID-19

Camous Moslemi et al. Transfusion. 2023 Jan.

Abstract

Background: Previous studies have reported Blood type O to confer a lower risk of SARS-CoV-2 infection, while secretor status and other blood groups have been suspected to have a similar effect as well.

Study design and methods: To determine whether any other blood groups influence testing positive for SARS-CoV-2, COVID-19 severity, or prolonged COVID-19, we used a large cohort of 650,156 Danish blood donors with varying available data for secretor status and blood groups ABO, Rh, Colton, Duffy, Diego, Dombrock, Kell, Kidd, Knops, Lewis, Lutheran, MNS, P1PK, Vel, and Yt. Of these, 36,068 tested positive for SARS-CoV-2 whereas 614,088 tested negative between 2020-02-17 and 2021-08-04. Associations between infection and blood groups were assessed using logistic regression models with sex and age as covariates.

Results: The Lewis blood group antigen Lea displayed strongly reduced SARS-CoV-2 susceptibility OR 0.85 CI[0.79-0.93] p < .001. Compared to blood type O, the blood types B, A, and AB were found more susceptible toward infection with ORs 1.1 CI[1.06-1.14] p < .001, 1.17 CI[1.14-1.2] p < .001, and 1.2 CI[1.14-1.26] p < .001, respectively. No susceptibility associations were found for the other 13 blood groups investigated. There was no association between any blood groups and COVID-19 hospitalization or long COVID-19. No secretor status associations were found.

Discussion: This study uncovers a new association to reduced SARS-CoV-2 susceptibility for Lewis type Lea and confirms the previous link to blood group O. The new association to Lea could be explained by a link between mucosal microbiome and SARS-CoV-2.

Keywords: ABO; COVID hospitalization; COVID severity; COVID susceptibility; COVID-19; Diego; Dombrock; Duffy; FUT2; FUT3; Kell; Kidd; Knops; Lewis; Lutheran; MNS; P1PK; Rh; SARS-CoV-2; Vel; Yt; blood antigen; blood groups; blood systems; long COVID symptoms; long COVID-19; secretor.

PubMed Disclaimer

Conflict of interest statement

Martin L Olsson and his spouse are inventors on patents about Vel blood group genotyping and own 50% each of the shares in BLUsang AB, an incorporated consulting firm which receives royalties for said patents. They are both co‐authors of AABB books and members of the Transfusion editorial board. Maria Didriksen received consultant fee for helping with a study tracking COVID‐19 infection among Falck Health Care Workers, which has no connection to the present study. All other authors declare no conflict of interest.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Zhao J, Yang Y, Huang H, et al. Relationship between the ABO blood group and the COVID‐19 susceptibility. medRxiv. 2020;19:54–63. 10.1101/2020.03.11.20031096 - DOI
    1. Gutiérrez‐Valencia M, Leache L, Librero J, Jericó C, Enguita Germán M, García‐Erce JA. ABO blood group and risk of COVID‐19 infection and complications: a systematic review and meta‐analysis. Transfusion. 2021;62:493–505. 10.1111/trf.16748 - DOI - PMC - PubMed
    1. Zhang Y, Garner R, Salehi S, La Rocca M, Duncan D. Association between ABO blood types and coronavirus disease 2019 (COVID‐19), genetic associations, and underlying molecular mechanisms: a literature review of 23 studies. Ann Hematol. 2021;100:1123–32. - PMC - PubMed
    1. Ellinghaus D, Degenhardt F, Bujanda L, et al. Genomewide association study of severe Covid‐19 with respiratory failure. N Engl J Med. 2020;383:1522–34. 10.1056/NEJMoa2020283 - DOI - PMC - PubMed
    1. Barnkob MB, Pottegård A, Støvring H, Haunstrup TM, Homburg K, Larsen R, et al. Reduced prevalence of SARS‐CoV‐2 infection in ABO blood group O. Blood Adv. 2020;4:4990–3. - PMC - PubMed

Publication types

Substances