ABO Blood Types and COVID-19: Spurious, Anecdotal, or Truly Important Relationships? A Reasoned Review of Available Data
Abstract
:1. Introduction
2. The ABO Blood Group System at a Glance
3. Hypotheses Linking ABO Types and COVID-19 and Their Consequences on the Interpretation of Reported Associations
3.1. The Anti-ABO Antibodies
3.2. The ABO Effect on Thrombosis
3.3. ABO Blood Groups and the Furin Cleavage Site
3.4. ABO Blood Groups and Susceptibility to Other COVID-19-Associated Risk Factors
3.5. ABO Blood Groups and the Microbiota
4. Studies Linking ABO Blood Types to COVID-19
4.1. Case–Control Studies Designed to Observe Associations
4.2. Studies Designed to Observe an Effect on Severity
4.3. Other Study Designs
5. Consequences of between-Populations Differences in ABO Blood Types Frequencies
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Country | Cases | Controls | ABO Effect a | Ref. | ||||
---|---|---|---|---|---|---|---|---|
Definition b | Number | Definition c | O | A | B | AB | ||
China | I | 1775 | I | <Risk | >Risk | ns | ns | [1] |
USA | I | 682 | I | <Risk | >Risk | ns | ns | [2] |
China | II | 2153 | I | <Risk | >Risk | ns | ns | [3] |
Turkey | I | 186 | III | <Risk | >Risk | ns | ns | [4] |
Spain/Italy d | III | 1610 | III + IV | <Risk | >Risk | ns | ns | [5] |
China | I | 187 | IV | <Risk | >Risk | ns | ns | [6] |
USA | V | 3239 | V | <Risk | >Risk | ns | ns | [7] |
China | III + IV | 97 | I | <Risk | >Risk | ns | ns | [8] |
Turkey | I | 179 | IV | <Risk | >Risk | ns | ns | [9] |
Iran | VII | 76 | I | <Risk | >Risk | ns | ns | [10] |
China | V | 134 | I | <Risk | >Risk | ns | ns | [11] |
Spain | VIII | 854 | VI | <Risk | >Risk | ns | ns | [12] |
Spain | IX | 965 | III | <Risk | >Risk | ns | ns | [12] |
UK | I | 86 | II | <Risk | >Risk | ns | ns | [35] |
Turkey | II | 1667 | I | <Risk | >Risk | ns | ns | [36] |
Iran | VI | 93 | I | <Risk | >Risk | >Risk | >Risk | [13] |
USA | I | 1289 | II | <Risk | ns | >Risk | >Risk | [14] |
Canada | I | 7071 | II | <Risk | ns | >Risk | >Risk | [15] |
India | I | 8102 | I | <Risk | ns | >Risk | ns | [16] |
Spain | II | 226 | I | <Risk | ns | >Risk | ns | [17] |
Saudi-Arabia | II | 72 | III | <Risk | ns | ns | >Risk | [18] |
Iran | I | 397 | IV | <Risk | ns | ns | >Risk | [19] |
USA + UK | I | 15,434 | II | <Risk | ns | ns | ns | [20] |
USA | I | 34,178 | II | <Risk | ns | ns | ns | [21] |
Denmark | V | 7422 | I | <Risk | ns | ns | ns | [22] |
International | I + II | 6696 + 3199 | II | <Risk | >Risk | [23] | ||
Italy | I | 447 | III | <Risk | ns | ns | ns | [24] |
China | II | 103 | II | ns | >Risk | ns | ns | [25] |
USA | I | 2417 | I | ns | >Risk | ns | ns | [26] |
Italy/Spain | III | 505 | VI | ns | >Risk | ns | >Risk | [27] |
Bahrain | V | 2334 | III | ns | ns | >Risk | <Risk | [28] |
Canada | V | 95 | I | ns | ns | ns | ns | [29] |
UK | V | 2244 | I | ns | ns | ns | ns | [37] |
Brazil | I | 2037 | II | ns | ns | ns | ns | [41] |
USA | II | 957 | IV | ns | ns | ns | ns | [38] |
Country | Type of Study | ABO Effect b | Ref. | |||
---|---|---|---|---|---|---|
O | A | B | AB | |||
Italy | Analysis of clinical and biological criteria among hypertensive COVID-19 patients | <risk | [30] | |||
Canada | Analysis of clinical and biological criteria among critically ill COVID-19 patients | <risk | >risk | <risk | >risk | [29] |
Spain | Analysis of the risk of death among COVID-19 patients requiring transfusion | <risk | ns | ns | [12] | |
Canada | Separate analyses of patients with or without severe illness | <risk | ns | >risk | >risk | [15] |
France | Comparison between patients who underwent transcatheter aortic valve replacement | ns | >risk | ns | ns | [31] |
Country | Type of Study | ABO Effect a | Ref. | |||
---|---|---|---|---|---|---|
O | A | B | AB | |||
Europe, Africa, Middle-East, Asia | Association between frequency of the A allele and COVID-19 prevalence across countries | >Risk | [32] | |||
Europe, Africa, Asia, America | Correlation between frequency of B+AB blood types and COVID-19 prevalence across countries | <Risk | [33] | |||
France | Comparison of ABO phenotypes of blood donors with SARS-CoV-2 neutralizing antibodies | <Risk | >Risk | ns | ns | [34] |
Italy | Comparison of ABO phenotypes of blood donors with SARS-CoV-2 anti-N antibodies | ns | ns | ns | ns | [39] |
France | Comparison of ABO phenotypes of COVID+ vs. COVID− aircraft carrier crew members | ns | ns | ns | ns | [40] |
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Pendu, J.L.; Breiman, A.; Rocher, J.; Dion, M.; Ruvoën-Clouet, N. ABO Blood Types and COVID-19: Spurious, Anecdotal, or Truly Important Relationships? A Reasoned Review of Available Data. Viruses 2021, 13, 160. https://doi.org/10.3390/v13020160
Pendu JL, Breiman A, Rocher J, Dion M, Ruvoën-Clouet N. ABO Blood Types and COVID-19: Spurious, Anecdotal, or Truly Important Relationships? A Reasoned Review of Available Data. Viruses. 2021; 13(2):160. https://doi.org/10.3390/v13020160
Chicago/Turabian StylePendu, Jacques Le, Adrien Breiman, Jézabel Rocher, Michel Dion, and Nathalie Ruvoën-Clouet. 2021. "ABO Blood Types and COVID-19: Spurious, Anecdotal, or Truly Important Relationships? A Reasoned Review of Available Data" Viruses 13, no. 2: 160. https://doi.org/10.3390/v13020160