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      Association of the ABO blood group with SARS‐CoV‐2 infection in a community with low infection rate


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          Background and objectives

          Reports on the association of the ABO phenotypes with infection by the SARS‐CoV‐2 virus have mostly come from countries with high infection rates. This study examined the possible association between SARS‐CoV‐2 infection and the ABO phenotype in Black Africa.

          Materials and methods

          This report is from a single centre where both asymptomatic and symptomatic patients were quarantined. At the time of this report, Oyo State, Nigeria had carried out 15 733 tests of which 3119 were positive for the virus with 1952 recoveries and 37 deaths. The ABO distribution of patients was compared with that of a blood donor population.


          Of the 302 participants, 297 (98%) had their blood group determined, asymptomatic and symptomatic individuals were 123 (40·7%) and 179 (59·3%) respectively. Blood group O was significantly less represented among the patients ( P < 0·01) while blood groups B and AB were significantly more represented ( P < 0·01, P = 0·03 respectively). Patients with anti‐B (groups A and O) were significantly less represented than those without anti‐B (B and/or AB): B and AB ( P < 0·001), B ( P = 0·002), AB ( P = 0·01). There was no difference in the blood group distribution of symptomatic and asymptomatic patients (χ 2 (3, N = 302) = 2·29; P = 0·51), but symptomatic patients with anti‐A (groups B and O) were more represented than asymptomatic patients with anti‐A (χ 2 4·89; P = 0·03).


          The higher prevalence of blood group O and more potent beta haemolysins (anti‐B antibodies) are likely reasons for the lower infectivity by the SARS‐CoV‐2 virus and severity of COVID‐19 disease in the community.

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          Most cited references23

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          Genomewide Association Study of Severe Covid-19 with Respiratory Failure

          Abstract Background There is considerable variation in disease behavior among patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (Covid-19). Genomewide association analysis may allow for the identification of potential genetic factors involved in the development of Covid-19. Methods We conducted a genomewide association study involving 1980 patients with Covid-19 and severe disease (defined as respiratory failure) at seven hospitals in the Italian and Spanish epicenters of the SARS-CoV-2 pandemic in Europe. After quality control and the exclusion of population outliers, 835 patients and 1255 control participants from Italy and 775 patients and 950 control participants from Spain were included in the final analysis. In total, we analyzed 8,582,968 single-nucleotide polymorphisms and conducted a meta-analysis of the two case–control panels. Results We detected cross-replicating associations with rs11385942 at locus 3p21.31 and with rs657152 at locus 9q34.2, which were significant at the genomewide level (P<5×10−8) in the meta-analysis of the two case–control panels (odds ratio, 1.77; 95% confidence interval [CI], 1.48 to 2.11; P=1.15×10−10; and odds ratio, 1.32; 95% CI, 1.20 to 1.47; P=4.95×10−8, respectively). At locus 3p21.31, the association signal spanned the genes SLC6A20, LZTFL1, CCR9, FYCO1, CXCR6 and XCR1. The association signal at locus 9q34.2 coincided with the ABO blood group locus; in this cohort, a blood-group–specific analysis showed a higher risk in blood group A than in other blood groups (odds ratio, 1.45; 95% CI, 1.20 to 1.75; P=1.48×10−4) and a protective effect in blood group O as compared with other blood groups (odds ratio, 0.65; 95% CI, 0.53 to 0.79; P=1.06×10−5). Conclusions We identified a 3p21.31 gene cluster as a genetic susceptibility locus in patients with Covid-19 with respiratory failure and confirmed a potential involvement of the ABO blood-group system. (Funded by Stein Erik Hagen and others.)
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            COVID‐19 patients' clinical characteristics, discharge rate, and fatality rate of meta‐analysis

            Abstract The aim of this study was to analyze the clinical data, discharge rate, and fatality rate of COVID‐19 patients for clinical help. The clinical data of COVID‐19 patients from December 2019 to February 2020 were retrieved from four databases. We statistically analyzed the clinical symptoms and laboratory results of COVID‐19 patients and explained the discharge rate and fatality rate with a single‐arm meta‐analysis. The available data of 1994 patients in 10 literatures were included in our study. The main clinical symptoms of COVID‐19 patients were fever (88.5%), cough (68.6%), myalgia or fatigue (35.8%), expectoration (28.2%), and dyspnea (21.9%). Minor symptoms include headache or dizziness (12.1%), diarrhea (4.8%), nausea and vomiting (3.9%). The results of the laboratory showed that the lymphocytopenia (64.5%), increase of C‐reactive protein (44.3%), increase of lactic dehydrogenase (28.3%), and leukocytopenia (29.4%) were more common. The results of single‐arm meta‐analysis showed that the male took a larger percentage in the gender distribution of COVID‐19 patients 60% (95% CI [0.54, 0.65]), the discharge rate of COVID‐19 patients was 52% (95% CI [0.34,0.70]), and the fatality rate was 5% (95% CI [0.01,0.11]).
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              Inhibition of the interaction between the SARS-CoV Spike protein and its cellular receptor by anti-histo-blood group antibodies

              Abstract Severe acute respiratory syndrome coronavirus (SARS-CoV) is a highly pathogenic emergent virus which replicates in cells that can express ABH histo-blood group antigens. The heavily glycosylated SARS-CoV spike (S) protein binds to angiotensin-converting enzyme 2 which serves as a cellular receptor. Epidemiological analysis of a hospital outbreak in Hong Kong revealed that blood group O was associated with a low risk of infection. In this study, we used a cellular model of adhesion to investigate whether natural antibodies of the ABO system could block the S protein and angiotensin-converting enzyme 2 interaction. To this aim, a C-terminally EGFP-tagged S protein was expressed in chinese hamster ovary cells cotransfected with an α1,2-fucosyltransferase and an A-transferase in order to coexpress the S glycoprotein ectodomain and the A antigen at the cell surface. We observed that the S protein/angiotensin-converting enzyme 2-dependent adhesion of these cells to an angiotensin-converting enzyme 2 expressing cell line was specifically inhibited by either a monoclonal or human natural anti-A antibodies, indicating that these antibodies may block the interaction between the virus and its receptor, thereby providing protection. In order to more fully appreciate the potential effect of the ABO polymorphism on the epidemiology of SARS, we built a mathematical model of the virus transmission dynamics that takes into account the protective effect of ABO natural antibodies. The model indicated that the ABO polymorphism could contribute to substantially reduce the virus transmission, affecting both the number of infected individuals and the kinetics of the epidemic.

                Author and article information

                Vox Sang
                Vox Sang
                Vox Sanguinis
                John Wiley and Sons Inc. (Hoboken )
                02 February 2021
                : 10.1111/vox.13077
                [ 1 ] Department of Haematology College of Medicine University of Ibadan Nigeria
                [ 2 ] Department of Orthopaedics and Trauma College of Medicine University of Ibadan Nigeria
                [ 3 ] Clinical Virology Unit, Medical Microbiology and Parasitology Department and Biorepository and Clinical Virology Laboratory College of Medicine University of Ibadan Nigeria
                [ 4 ] Department of Chemical Pathology University College Hospital Ibadan Nigeria
                [ 5 ] Oyo State Ministry of Health Ibadan Nigeria
                Author notes
                [*] [* ] * Correspondence: Dr Taiwo R Kotila, Department of Haematology, University College Hospital, PMB 5116, Ibadan, Nigeria.

                Email: tkotila@ 123456com.ui.edu.ng

                Author information
                © 2021 International Society of Blood Transfusion

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                : 24 December 2020
                : 26 October 2020
                : 27 December 2020
                Page count
                Figures: 1, Tables: 3, Pages: 0, Words: 7314
                Funded by: Oyo State Ministry of Health, Ibadan, Nigeria
                Original Paper
                Original Papers
                Custom metadata
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.1 mode:remove_FC converted:01.04.2021

                antibodies,blood group,covid‐19,haemolysin,isoagglutinins,serology
                antibodies, blood group, covid‐19, haemolysin, isoagglutinins, serology


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