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Meta-Analysis
. 2023 Nov 14;23(1):797.
doi: 10.1186/s12879-023-08792-x.

ABO and Rh blood groups and risk of infection: systematic review and meta-analysis

Emily Ana Butler  1   2 , Rushil Parikh  3 , Sonia M Grandi  2   4 , Joel G Ray #  1   5 , Eyal Cohen #  6   7   8
Affiliations
Meta-Analysis

ABO and Rh blood groups and risk of infection: systematic review and meta-analysis

Emily Ana Butler et al. BMC Infect Dis. .

Abstract

Background: Persons with non-O and Rh-positive blood types are purported to be more susceptible to infection, including SARS-CoV-2, but there remains uncertainty about the degree to which this is so for both non-viral and viral infections.

Methods: We systematically reviewed Embase and PubMed from January 1st 1960 to May 31st 2022. English-language publications were selected that separately investigated the relation between ABO and/or Rh blood group and risk of SARS-CoV-2 and non-SARS-CoV-2 infection. Pooled odds ratios (ORp) and 95% confidence intervals (CI) were then generated for each.

Results: Non-O blood groups had a higher ORp for SARS-CoV-2 than O blood groups, both within 22 case-control studies (2.13, 95% CI 1.49- 3.04) and 15 cohort studies (1.89, 95% CI 1.56- 2.29). For non-SARS-CoV-2 viral infections, the respective ORp were 1.98 (95% CI 1.49-2.65; 4 case-control studies) and 1.87 (95% CI 1.53-2.29; 12 cohort studies). For non-viral infections, the ORp were 1.56 (95% CI 0.98-2.46; 13 case-control studies) and 2.11 (95% CI 1.67-6.67; 4 cohort studies). Rh-positive status had a higher ORp for SARS-CoV-2 infection within 6 case-control studies (13.83, 95% CI 6.18-30.96) and 6 cohort studies (19.04, 95% CI 11.63-31.17), compared to Rh-negative persons. For Rh status, non-SARS-CoV-2 infections, the ORp were 23.45 (95% CI 16.28-33.76) among 7 case-control studies, and 9.25 (95% CI 2.72-31.48) within 4 cohort studies. High measures of heterogeneity were notably observed for all analyses.

Conclusions: Non-O and Rh-positive blood status are each associated with a higher risk of SARS-CoV-2 infection, in addition to other viral and non-viral infections.

Keywords: ABO; Infection; Meta-analysis; Rh(D); SARS-CoV-2.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of study selection and inclusion
Fig. 2
Fig. 2
a Risk of SARS-CoV-2 infection comparing non-O vs. O blood groups, among case–control studies. b Risk of SARS-CoV-2 infection comparing non-O vs. O blood groups, among cohort studies
Fig. 3
Fig. 3
a Risk of non-SARS-CoV-2 infections comparing non-O vs. O blood groups, among case–control studies. Shown are studies of viral infections (upper) and non-viral infections (lower). b Risk of non-SARS-CoV-2 infections comparing non-O vs. O blood groups, among cohort studies. Shown are studies of viral infections (upper) and non-viral infections (lower)
Fig. 4
Fig. 4
Risk of SARS-CoV-2 infection comparing Rh-positive vs. Rh-negative status, amongcase-control studies (upper) and cohort studies (lower)
Fig. 5
Fig. 5
Risk of non-SARS-CoV-2 infections comparing Rh-positive vs. Rh-negative status, among case–control studies (upper) and cohort studies (lower)
See this image and copyright information in PMC

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