Controls: 500
Summary of findings table. Relationship between ABO blood group and occurrence and severity of COVID-19
COVID-19 infected subjects and uninfected controls. Inpatients and Outpatients. ABO prevalence among COVID-19 infected and non-infected individuals; ABO prevalence in patients with severe or non-severe COVID-19 infections. | ||||||
---|---|---|---|---|---|---|
Outcomes | Illustrative comparative risks (95% CI) | Relative effect (95% CI) | N. of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
382,537/892,496 (42.8%) | 34.6% (32.1/36.8%) | OR, 0.81 (0.75/0.86) | 922,145 (16; 18 cohorts) | ⊕⊝⊝⊝ | There was evidence that individuals with blood group 0 had a decreased risk of SARS-COV-2 infection | |
81,183/184,966 (43.8%) | 31.9% (28.0/36.3%) | OR, 0.73 (0.64/0.83) | 193,112 (10; 12 cohorts) | ⊕⊝⊝⊝ | There was evidence that individuals with blood group 0 had a decreased risk of SARS-COV-2 infection | |
301,354/707,530 (42.5%) | 37.8% (36.1/39.9%) | OR, 0.89 (0.85/0.94) | 729,033 (7) | ⊕⊕⊝⊝ | There was evidence that individuals with blood group 0 had a decreased risk of SARS-COV-2 infection. However, compared to case-control studies, the magnitude of the effect size in cohort studies was significantly lower | |
1,083/5,541 (19.5%) | 19.5% (17.7/21.2%) | RR, 1.00 (0.91/1.09) | 9,147 (7) | ⊕⊕⊝⊝ | Overall, individuals with blood group 0 had the same risk of severe SARS-CoV-2 infection compared to individuals with non-0 blood group |
GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. CI: confidence interval; RR: risk ratio.
The role of the O-type blood group in SARS-CoV-2 infection was evaluated comparing the prevalence of O type in infected patients (cases) and in non-infected subjects (controls). The meta-analysis was performed using the inverse variance (IV) method for study weighting, pooling odd ratios (ORs) and/or risk ratios (RRs) at study level. A random-effects approach was followed, with DerSimonian-Laird estimator for tau. The I -squared index for inconsistence was calculated to address the heterogeneity between studies.
The effect size calculation for case-control studies is based on the prevalence of the exposure in the diseased and in the not diseased, and should be calculated with an OR ratio 20 . In any case, often the OR is a good approximation of RR, especially if the incidence in both exposed and not exposed is low (<10%) and the true RR remains close to 1. For cohort studies, we evaluated the mean relative risk (RR) for the infection as this represents a more understandable quantification of effect size and preventable fraction in the exposed population (PFE).
Subgroup analysis was carried out according to the study design (case control or cohort). Differences in effect size between case control and cohort studies were evaluated with a test for subgroup difference. p<0.1 was considered to be a statistically significant subgroup effect 21 . Stata 16.1 and package “meta” with R version 4.0.3 software were used to perform calculations.
Overall, we identified 746 references through electronic and manual searches ( Figure 1 ). Seven hundred and eight studies were excluded as duplicates or as not relevant to this review according to the title and/or abstract. After reading the full text of the remaining 38 potentially eligible studies, 17 were excluded (reviews, commentaries, non-peer reviewed publication, insufficient data). Only those studies fulfilling the selection criteria were included in the final analysis. Thus, for this systematic review, we considered 21 studies fulfilling our pre-specified criteria 22 – 42 . Table I summarises the main characteristics and results of these studies. Some studies included different cohorts of patients and, where 2×2 data were available, we calculated separate ORs for each cohort. Ellinghaus et al . provided data from Italian and Spanish hospitals 22 . Leaf et al . 31 stratified the analysis according to race/ethnicity (White non-Hispanic, Black non-Hispanic, Asian non-Hispanic, and Hispanic). Zhao et al . 36 collected patients and controls at the Jinyintan Hospital in Wuhan, and at Shenzhen Hospital, Guangdong Province, in the People’s Republic of China. In a Spanish study, Muñiz-Diaz et al . 41 included a cohort of blood donors recruited for convalescent plasma donation after recovering from a mild SARS-CoV-2 infection, and a cohort of patients with severe SARS-CoV-2 infection who were transfused during hospitalisation (donors and transfused).
Flow chart of the selection of studies
The NOS checklists for individual studies are presented in the Online Supplementary Content (Tables SI–SIII) . In cohort studies, the quality was judged high for both the outcomes analysed since all studies achieved from 7 to 9 stars. For the outcome prevalence of COVID-19 in case control studies, the NOS score was <7 in 8 of the 11 case control studies ( Online Supplementary Table SII ).
Publication bias was evaluated for the outcome prevalence of infection. On the whole, the asymmetric aspect of the funnel plot seems to be at least partly due to the different distributions of the study effect sizes according to the study designs ( Online Supplementary Figures S1 and S2 ). When the two designs were examined jointly, the Egger test was significant (p=0.025); however, when the two designs were examined separately the significance was lost.
Outcome: prevalence of o type vs non-o blood types in sars-cov-2 infected patients.
The outcome prevalence of ABO groups in COVID-19 infected or non-infected individuals was reported in 17 studies, including 7 cohort studies 24 , 28 , 30 , 37 – 39 , 42 and 10 case control studies 22 , 23 , 25 – 27 , 29 , 32 , 33 , 36 , 41 . Figure 2 reports the forest plot of the prevalence of the blood group O vs non-O types in cases (infected SARS-CoV-2 patients) and control (non-infected) subjects. The role of the O-type blood group in SARS-CoV-2 infection was evaluated in 17 studies, accounting for 19 2×2 tables. Overall mean OR was 0.81 (95% confidence interval [CI]: 0.75, 0.86). The effect was significantly different from the null hypothesis of absence of effect by O type on the probability of SARS-CoV-2 infection (z=6.19, p<0.0001). The effect was protective, suggesting a lower risk in subjects of O type. The quality of the evidence was graded as very low for inconsistency due to heterogeneity, and for risk of biases in case control studies (confounding, selection, ascertainment) ( Table II ). The mean OR of case control studies was 0.73 (95% CI: 0.64, 0.83), whereas the mean OR of cohort studies was 0.89 (95% CI: 0.85, 0.94). Thus, the null hypothesis of OR=1 was rejected in both cases, but the difference in the effect size was significantly lower in cohort studies compared to case control studies (test for subgroup difference: Q=8.31, degree of freedom: 1, p=0.0039).
Forest plot of the prevalence of the blood group 0 vs non-0 types in cases (infected SARS-CoV-2 patients) and control (uninfected) subjects
Mean RR, evaluated in cohort studies, was 0.92 (95% CI: 0.87, 0.97), with z-score=3.21, p=0.001, and substantial heterogeneity ( I -squared=72.7%). PFE was 8.1% (95% CI: 3.2%, 12.7%). The quality of the evidence in cohort studies was graded as low due to inconsistency, and because not all the studies performed matching or adjustment of plausible prognostic variables.
The differential exposure to O blood group in cases (severe infection) and controls (non-severe infection) was expressed as RR, and the RRs were then pooled using a random-effect model. The outcome severity of SARS-CoV-2 infection was reported in 14 studies 23 , 25 , 27 , 29 , 30 – 32 , 34 – 36 , 38 – 40 , 42 . The severity of the disease was not uniformly defined in the cohorts of infected patients, and 8 endpoints of severity were assessed, each vs the opposite condition. The endpoints included in the selected studies were: i) severe vs non-severe clinical disease (7 studies) 23 , 27 , 29 , 30 , 34 , 38 , 40 ; ii) death (11 studies) 25 , 29 – 32 , 34 – 36 , 39 , 40 ; iii) hospitalisation vs non-hospitalisation (1 study) 42 ; iv) need for intubation (4 studies) 29 – 31 , 39 ; v) requirement of proning in the treatment of respiratory insufficiency (1 study) 30 ; vi) acute kidney injury at admission (1 study) 31 ; vii) shock (1 study) 31 ; viii) thrombosis (1 study) 40 .
Endpoints indicating clinical severity and related O type distribution are summarised in Figure 3 ; none were significantly associated to the O type blood group. In other words, no evidence was found indicating an effect of the O type on the disease severity in the infected patients. The RR was 1.0 (95% CI: 0.92–1.09) for the endpoint severe infection, and 0.95 (95% CI: 0.89–1.02) for death. The quality of the evidence was graded as low due to imprecision (95% CI includes line of no effect), and because not all the studies adjusted for prognostic factors
Forest plot of the severity of SARS-CoV-2 infection according to blood group (O vs non-O blood group)
Due to the severity of the disease, mostly unpredictable, the identification of risk factors associated with SARS-CoV-2 infection and outcomes has become a research priority. Thus, following the first reports in literature on the association between ABO blood group and COVID-19, this has been the focus of attention in a number of investigative studies and, in particular, whether ABO blood type was associated not only with COVID-19 onset but also with its severity and disease-related mortality 43 . This growing interest is not surprising considering that the study of the interaction between ABO blood system and infections has a long history and extensive literature 12 . Individuals with blood group O were reported to be more susceptible to Norovirus, and also had a significantly higher prevalence of Helicobacter pylori , but were less susceptible to SARS and hepatitis B virus 11 , 44 – 47 . In another study, blood group A was associated with an increased risk of acute respiratory distress syndrome (ARDS) in trauma and sepsis patients 48 . A study by Lebiush et al . on influenza A (H1N1) observed a higher seroconversion rate in blood groups A and B 49 . Elnady et al . found that individuals with blood type A were more susceptible to rotavirus gastroenteritis than those with blood type B 50 . Among patients infected with dengue virus, Murugananthan et al . found that individuals with AB blood type had a 2.5 times higher risk of developing dengue haemorrhagic fever than those with other blood types 51 . Finally, there is strong evidence that ABO phenotype modulates severity of Plasmodium falciparum- associated malaria, with group A associated with severe disease and blood group O with milder disease 52 .
Regarding the issue of this systematic review, the first reports on the evidence of a relationship between SARS-CoV-2 infection and ABO blood groups were published early in China and so far 21 articles have been published worldwide, covering a large number of cases. The pathogenic mechanism underlying this association is quite complex and encompasses several molecular pathways. Further experimental studies are needed to better characterise the role of anti-SARS-CoV-2 neutralising anti-A IgG antibodies in COVID-19 onset, and the importance of plasma VWF/FVIII levels and endothelial cell activation in COVID-19-induced coagulopathy and pulmonary microvascular occlusion 17 , 53 . Whatever the underlying mechanism, this correlation is quite intriguing as it allows us to make some considerations that could have potentially important implications. First, the ABO-driven COVID-19 susceptibility could account for the inter-ethnic epidemiological difference in SARS-CoV-2 infection. Indeed, Africa is the continent with the lowest number of cases and deaths (1,044,513 confirmed cases with 21,722 deaths at 30 th August 2020; data available at: https://covid19.who.int/ ). Curiously, among the different ethnicities, Africans have the highest percentage of O blood type (up to 60%). Another interesting observation regards the distribution of COVID-19 across different ages and genders. In fact, it is equally well known that men and the elderly are more affected by SARS-CoV-2 infection than women and young people. Previous studies had demonstrated that women with O blood type have higher anti-A IgG antibody levels than males, and that the titer of anti-A and anti-B isoagglutinins declines with age 54 , 55 . Although these findings do not constitute the definitive proof of the causal association between ABO blood type and gender-, age- and ethnic-related differences in the epidemiological distribution of COVID-19, these considerations are quite curious and deserve further investigation.
The results of this systematic review, which are in agreement with those published in another recent meta-analysis 15 , indicate the lower susceptibility of O blood type individuals to being infected by SARS-CoV-2 than non-O subjects. The investigational hypothesis of a protective effect exerted by the O type on the risk of the SARS-CoV-2 infection was confirmed by both study designs, case control and cohort. However, the effect size was lower in cohort studies compared to case control studies. This is not surprising since, compared to cohort design, case control studies are more susceptible to bias due to confounding co-variates with different distributions in cases (infected patients) and the control population. Sample size for case control studies is based on prevalence of exposure, not on incidence of outcome. Because the prevalence of the exposure is usually larger than the incidence of outcome, in most practical situations a case control study is more powerful than a cohort study for the same problem. On the other hand, case control studies are very likely to suffer from bias. Controls should be drawn from the same general population that gave rise to the cases. However, in practice, the comparability of cases and controls is difficult to achieve, making this aspect the Achilles heel of case control design. In the present systematic review, no evidence was found indicating an effect of the O blood type on the disease severity in the infected patients. Larger, well-designed epidemiological trials are, however, needed to clarify the relationship between the ABO blood group system and the risk of developing COVID-19 or a more severe disease.
The Authors declare no conflicts of interest.
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Evolutionary aspects of abo blood group in humans., association of the blood groups with mostly public diseases, genetic determinants of extreme longevity: the role of abo blood group, relationship between abo blood group and pregnancy complications: a systematic literature analysis., association of the abo blood group with certain human diseases, chemical basis of abo subgroups insights into blood group a subtypes revealed by glycolipid analysis, beyond immunohaematology: the role of the abo blood group in human diseases., blood group distribution and life-expectancy: a single-centre experience., abo research in the modern era of genomics., the role of abo blood type in thrombosis scoring systems, 116 references, molecular genetics of abo., biochemistry and genetics of the abo, lewis, and p blood group systems., abh and related histo‐blood group antigens; immunochemical differences in carrier isotypes and their distribution 1, polymorphism and recombination events at the abo locus: a major challenge for genomic abo blood grouping strategies, molecular genetic basis of the histo-blood group abo system, design of the blood group ab glycotope, blood group antigens as tumor markers, parasitic/bacterial/viral receptors, and their association with immunologically important proteins., modifying the red cell surface: towards an abo‐universal blood supply, the abo blood group gene: a locus of considerable genetic diversity., genomic analysis of clinical samples with serologic abo blood grouping discrepancies: identification of 15 novel a and b subgroup alleles., related papers.
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The Remains of the Body is not a manual on queer literature and behaviour. It simply is a juicy story and like blood, the story moves through our veins and arteries.
In the course of our lifetime, all we do is crave for companionship. It drives our emotions, perspectives, and the need to make our life worthy of living. Saikat Majumdar’s recent novel, The Remains of the Body is not just a story about people exploring sexuality. It also cultivates the different ideas of relationship they build by relying on pleasure, freedom and where or how all of them get restricted. Cis/het men often fail to understand the fundamentals of queer literature. It comes with the conditioning which is based on conclusions and not on understanding. Yet, if read by breaking the conditioning we are pushed to adopt, queer literature holds the ability to wash away the linings of gender. This particular work of Saikat Majumdar made the man in me hard and melted the woman that likes to come out of me by coating my body with warmth, shivers and excitement.
The story revolves around three friends, Avik, Kaustav and Sunetra. While Avik and Kaustav happen to be childhood buddies, Sunetra is the person who works as the trigger factor. She allows both the men to understand their choices. The story has been told by an observer who manages to know the bits and pieces of these three interconnected individuals. It is easy to write a steamy novel with repetitive graphic sex making the book a source of quick orgasm. What perfumes readers is when they get to devour the sexual tension between characters by keeping love and lust in homeostasis. It does not exhaust the readers and elevates the orgasm of a thought more than what is so usual. The writer succeeds in putting a seed of the intention of the book. The titration of bisexuality complements the same sex tension and vice-versa. The steam of the story/characters condenses and rains. Subsequently, drenching the reader irrespective of gender, class, caste or race.
The somatic growth of the story allows the readers to be with the body of the characters. The words, on the other hand, magnify the mind for those who want to know the psyche behind the culture of sensuality and sensitivity. Most of us are not fond of going beyond the body. Thus, the author establishes a common origin wherein we get to understand the consequence of touch to a very molecular level. So, the author makes lust appear with absolute reality. The body hair, erect nipples, radiant thighs etc., are often used to define the content of the mind. At the same time, the constricted hands of marriage, constituents of friendship, emotional vulnerability of the characters help in creating a definition of body. The torment inside Kaustav is often found in people who struggle to commit to their own choices. So, when he feels the touch of Sunetra, he is afraid to accept his own emotion. Her touch mostly overpowers his feeling towards Avik, his growing bulge and also the visuals of his naked body. It makes the reader look beyond a single choice of an individual. The tension possesses the power to haunt and seduce the reader.
In the context of most notorious books, fantasies take an upper hand over their source. So, in the book, Emmanuelle by Emmanuelle Arsan, the author graphically develops the image of breasts, orgasm and the saliva dripping of their mouths. The same happens in the books of Marquis de Sade or Henry Miller. In this book, the author does not allow his own visuals about sex take the upper hand. So, even the Avik and Sunetra’s romance outside and around marriage reveals the discomfort in their marital life more than the lustrous thought of multiple partners. As human beings, we are fond of provoking our own thoughts, but a late orgasm is the result of good literature. The fantasies of these three individuals describe how people discover their own sexual choices in real life. Despite the moral constructs around our fantasies, the author subtly screams how if we do not break these heavy walls, everything else is going to stop us from telling and imagining them.
BY Anjana Basu
The author’s idea of marriage is that of an ideal individual. The society does not work to embrace a kind of marriage that ideal individuals keep before us as thinkers or readers. We are libertines when it comes to relationship. To keep a single relationship fertile, we work on it by exhausting our very self. And if we let our thoughts pass through monogamy, the entire act is referred to as perversion. The book does not offer a conclusion, but every reader wants to have one. So, in this book, Avik, Kaustav and Sunetra behave as libertines mostly do. It should be the only way to explore our deepest secrets.
The Remains of the Body is not a manual on queer literature and behaviour. It simply is a juicy story and like blood, the story moves through our veins and arteries. We have to feel what the story does to us. That would be the answer to all our questions. It is a kind of love that wears a leather thong.
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ABO Blood-Group System - Science topic. The major human blood type system which depends on the presence or absence of two antigens A and B. Type O occurs when neither A nor B is present and AB ...
The ABO blood group has been associated with many diseases and easily accessed in a patient's genetic makeup . In the years 1960 and 1970, large epidemiological studies were carried out around the world and connections between the human ABO blood group and vulnerability to develop a number of diseases were broadly postulated .
The molecular basis of the ABO blood group system was elucidated in 1990. 7 The gene encodes a glycosyltransferase, which transfers N-acetyl D-galactosamine (group A) or D-galactose (group B) to the nonreducing ends of glycans on glycoproteins and glycolipids.The group O phenotype results from inactivation of the A1 glycosyltransferase gene, and the nonreducing ends of the corresponding ...
AB0 blood group antigens were discovered over a century ago; however, it is still important to study their role in development of various pathological conditions. ... [Blood group and human diseases (review of literature)] Klin Lab Diagn. 2020;65(4):216-221. doi: 10.18821/0869-2084-2020-65-4-216-221. [Article in Russian] Authors F N Gilmiyarova ...
Therefore, this review mainly presents a clinical overview and perspective of emerging technologies in blood group testing based on the literature. Collectively, this may highlight the most promising strategies and promote blood group typing development to ensure blood transfusion safety. ... The ABO blood group system revisited: a review and ...
However, malaria types were rarely stated in the literature . According to the ABO phenotype, there are some variations in Lewis antigen level among A, B, and AB blood types, ... Green C. The ABO, Lewis and related blood group antigens; a review of structure and biosynthesis. FEMS Microbiology Immunology. 1989; 1 (6-7):321-330. doi: ...
Eligibility criteria encompassed studies published in the English language, enrolling a minimum of 10 human participants, and that assessed ABO or Rh factor blood groups and risk of infection within a case-control or cohort study design. Included were articles published between January 1, 1960 and May 31, 2022 (for non-SARS-CoV-2 studies), or ...
Objective: To determine the spectrum of phenotypes linked to the ABO blood group system, using genetic determinants of the ABO blood group system. Approach and Results: We assessed the risk of 41 health and disease outcomes, and 36 linear traits associated with the ABO blood group system in the UK Biobank cohort. A total of 406 755 unrelated individuals were included in this study. Blood ...
Several studies have suggested that patients with non-O blood group have an increased risk of both venous and arterial thromboembolic events. On the contrary, the role of ABO blood group on the risk of bleeding complications remains unclear. Thus, we performed a meta-analysis of the literature with the aim of assessing this potential association.
Blood group might also be associated with the susceptibility for SARS‐CoV‐2 infection and also with the risk of developing severe COVID‐19. ... Mengoli C, Marano G, Candura F, Lopez N, et al. ABO blood group and COVID‐19: an updated systematic literature review and meta‐analysis. Blood Transfus. 2021; 19:317-26. [PMC free article ...
International Society of Blood Transfusion has recently recognized 33 blood group systems. Apart from ABO and Rhesus system, many other types of antigens have been noticed on the red cell membranes. Blood grouping and cross-matching is one of the few important tests that the anaesthesiologist orders during perioperative period.
The term "blood group" refers to the entire blood. group system comprising red blood cell (RBC) antigens whose specificity is controlled by a series. of genes which can be allelic or linked ...
STUDY OF BLOOD GROUP ANALYSIS AND ITS CORRELATION WITH ... - medRxiv
Hosseini-Maaf B, Smart E, Chester MA, Olsson ML. The Abantu phenotype in the ABO blood group system is due to a splice-site mutation in a hybrid between a new O1 -like allelic lineage and the A2 allele. Vox Sang 2005;88:256-64. 10.1111/j.1423-0410.2005.00626.x 15877647 Search in Google Scholar.
A Novel Approach to Predict Blood Group using Fingerprint Map Reading. April 2021. DOI: 10.1109/I2CT51068.2021.9418114. Conference: 2021 6th International Conference for Convergence in Technology ...
Introduction. The ABO blood group system is used to characterise the ABO blood groups by the presence of A, B or AB antigens. 1 The blood groups are identified depending on the expression of specific carbohydrate sugars on the surface of red blood cells such as N-acetylgalactosamine and D-galactose for A and B antigen, respectively. 2 These sugars are structured on the H antigen in which blood ...
The literature review specificity discusses all the methods used in Sect. ... 5.1 Blood group. As per literature, all authors attempt traditional method for sample collection as ink and paper, so they were only analyses the fingerprint patterns visible to human eyes those are like Loops, Arches and Whorls. ...
This Meta-analysis showed that blood group type A has a greater risk of developing CC, while blood group type O was associated with lower chances of CC. ... A Systematic Literature Review and Meta-Analysis Asian Pac J Cancer Prev. 2023 Aug 1;24(8):2555-2563. doi: 10.31557/APJCP.2023.24.8.2555. Authors Mansour ...
Numerous studies have been conducted to investigate the relationship between ABO and Rhesus (Rh) blood groups and various health outcomes. However, a comprehensive evaluation of the robustness of these associations is still lacking. We searched PubMed, Web of Science, Embase, Scopus, Cochrane, and several regional databases from their inception until Feb 16, 2024, with the aim of identifying ...
review and update. J.R. Storry and M.L. Olsson. The antigens of the ABO system were the rst to be recognized as. blood groups and actually the rst human genetic markers known. Their presence and ...
Laboratory tests revealed increased white blood cell and neutrophil count, but no eosinophil count. The white blood cell count was 33.62 × 10 9 /L, while the neutrophil cell count was 18.5 × 10 9 /L. The high-sensitive C-reactive protein was 11.0 mg/L. Liver transaminase and myocardial enzymes were increased with abnormal coagulation function.
Following the first reports in the literature, the association between the ABO blood group and SARS-CoV-2 infection has been investigated by a number of studies, although with varying results. The main object of this systematic review was to assess the relationship between the ABO blood group and the occurrence and severity of COVID-19.
(d) In Rh blood group systems, we include only D antigen, while other antigens like C, c, e and E can influence the D antigen frequency. Conclusion. All mankind shares common blood group systems but with variable frequencies in different ethnic groups, geographical regions and races . In this systematic review, we made an effort to know the ...
An intensive survey of literature showed a huge number of studies on human blood groups and their implications. Thus, the findings of Kamil et al. (2010) in Libya; Zhang et al. (2012) in Minnesota ...
A review of key findings and recent progress made toward further understanding of this surprisingly polymorphic system of antigens of the ABO system is summarized. Abstract The antigens of the ABO system were the first to be recognized as blood groups and actually the first human genetic markers known. Their presence and the realization of naturally occurring antibodies to those antigens ...
The Remains Of The Body Review: The Body Fantasises Touch And Glory The Remains of the Body is not a manual on queer literature and behaviour. It simply is a juicy story and like blood, the story ...