Association Between ABO Blood Group, COVID-19 Status, and Early Respiratory Outcomes in Acute Pulmonary Embolism: An Interaction Analysis

Eddin, Abdulkader Jamal; Stanciugelu, Stefan-Iulian; Damian, Arnaldo Dario; Nitusca, Diana; Tunea, Oana Elena; Mozos, Ioana Monica

doi:10.3390/jcdd13050212

Open AccessArticle

Association Between ABO Blood Group, COVID-19 Status, and Early Respiratory Outcomes in Acute Pulmonary Embolism: An Interaction Analysis

by

Abdulkader Jamal Eddin

^1,2,3

,

Stefan-Iulian Stanciugelu

^4,5,*

,

Arnaldo Dario Damian

⁶,

Diana Nitusca

^7,8

,

Oana Elena Tunea

^9,10

and

Ioana Monica Mozos

^2,11

¹

Doctoral School, “Victor Babeş” University of Medicine and Pharmacy, 300041 Timişoara, Romania

²

Center for Translational Research and Systems Medicine, “Victor Babeş” University of Medicine and Pharmacy, 300173 Timişoara, Romania

³

Gastroenterology and Hepatology Clinic, “Pius Brînzeu” County Emergency Clinical Hospital, 300723 Timişoara, Romania

⁴

Orthopedics II Research Center, “Pius Brînzeu” County Emergency Clinical Hospital, 300723 Timişoara, Romania

⁵

Orthopedics Clinic II, “Pius Brînzeu” County Emergency Clinical Hospital, 300723 Timişoara, Romania

⁶

Neurology Clinic II, “Pius Brînzeu” County Emergency Clinical Hospital, 300723 Timişoara, Romania

⁷

Department of Biochemistry and Pharmacology, “Victor Babeş” University of Medicine and Pharmacy, Pta Eftimie Murgu Nr. 2, 300041 Timisoara, Romania

⁸

Center for Complex Networks Science, “Victor Babeş” University of Medicine and Pharmacy, Pta Eftimie Murgu Nr. 2, 300041 Timisoara, Romania

⁹

Advanced Research Center in Cardiovascular Pathology and Hemostaseology, “Victor Babeş” University of Medicine and Pharmacy, 300173 Timişoara, Romania

¹⁰

Internal Medicine Clinic, Emergency Municipal Clinical Hospital, 300041 Timişoara, Romania

¹¹

Department of Functional Sciences-Pathophysiology, “Victor Babeş” University of Medicine and Pharmacy, 300173 Timişoara, Romania

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Author to whom correspondence should be addressed.

J. Cardiovasc. Dev. Dis. 2026, 13(5), 212; https://doi.org/10.3390/jcdd13050212

Submission received: 7 March 2026 / Revised: 3 May 2026 / Accepted: 8 May 2026 / Published: 14 May 2026

(This article belongs to the Special Issue Acute Pulmonary Embolism: A Cardiovascular Emergency)

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Abstract

The influence of COVID-19 infection on the association between ABO blood groups and early outcomes in patients with acute pulmonary embolism (PE) remains uncertain. We conducted a retrospective, single-center cohort study including adult patients admitted with a first episode of acute pulmonary embolism (PE). The interaction between ABO blood group (non-O vs. O) and COVID-19 status was evaluated using multivariable logistic regression models adjusted for PE severity assessed by the Pulmonary Embolism Severity Index (PESI). A total of 211 patients were included, of whom 95 (45.0%) were COVID-19-positive. Among COVID-19-positive patients, non-O blood groups were associated with significantly higher odds of invasive mechanical ventilation (IMV) compared with group O (adjusted odds ratio [aOR] 12.87, 95% CI 4.17–39.75), whereas no association was observed among COVID-19–negative patients (aOR 1.20, 95% CI 0.45–3.23). No interaction was identified for 24 h mortality (p = 0.721) or systemic thrombolysis (p = 0.306). Higher PESI class was independently associated with an increased risk of adverse outcomes. ABO blood group modified the association between COVID-19 infection and early respiratory outcomes in acute PE. These findings suggest a potential role of ABO-related differences in coagulation and endothelial biology in the clinical expression of COVID-associated PE and should be interpreted as hypothesis-generating.

Keywords: ABO blood group; pulmonary embolism; COVID-19; venous thromboembolism; endothelial dysfunction; invasive mechanical ventilation; Pulmonary Embolism Severity Index

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MDPI and ACS Style

Eddin, A.J.; Stanciugelu, S.-I.; Damian, A.D.; Nitusca, D.; Tunea, O.E.; Mozos, I.M. Association Between ABO Blood Group, COVID-19 Status, and Early Respiratory Outcomes in Acute Pulmonary Embolism: An Interaction Analysis. J. Cardiovasc. Dev. Dis. 2026, 13, 212. https://doi.org/10.3390/jcdd13050212

AMA Style

Eddin AJ, Stanciugelu S-I, Damian AD, Nitusca D, Tunea OE, Mozos IM. Association Between ABO Blood Group, COVID-19 Status, and Early Respiratory Outcomes in Acute Pulmonary Embolism: An Interaction Analysis. Journal of Cardiovascular Development and Disease. 2026; 13(5):212. https://doi.org/10.3390/jcdd13050212

Chicago/Turabian Style

Eddin, Abdulkader Jamal, Stefan-Iulian Stanciugelu, Arnaldo Dario Damian, Diana Nitusca, Oana Elena Tunea, and Ioana Monica Mozos. 2026. "Association Between ABO Blood Group, COVID-19 Status, and Early Respiratory Outcomes in Acute Pulmonary Embolism: An Interaction Analysis" Journal of Cardiovascular Development and Disease 13, no. 5: 212. https://doi.org/10.3390/jcdd13050212

APA Style

Eddin, A. J., Stanciugelu, S.-I., Damian, A. D., Nitusca, D., Tunea, O. E., & Mozos, I. M. (2026). Association Between ABO Blood Group, COVID-19 Status, and Early Respiratory Outcomes in Acute Pulmonary Embolism: An Interaction Analysis. Journal of Cardiovascular Development and Disease, 13(5), 212. https://doi.org/10.3390/jcdd13050212

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Association Between ABO Blood Group, COVID-19 Status, and Early Respiratory Outcomes in Acute Pulmonary Embolism: An Interaction Analysis

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