Iberoamerican Journal of Medicine
Iberoamerican Journal of Medicine
Original article

ABO blood groups among Coronavirus disease 2019 patients

Tasneem A. Alkout, Abdulhamid M. Alkout

Downloads: 26
Views: 1981


Introduction: Susceptibility to some infectious diseases has been associated with blood group phenotypes. Coronavirus disease 2019 (COVID-19) is a new infectious disease caused by a novel corona virus designated Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which has spread rapidly around the world.
The objective of this study was to determine if the susceptibility or severity to COVID-19 was associated with ABO blood group distribution among the affected countries.
Materials and methods: This retrospective study of COVID-19 disease was based on data from 105 countries collected on the 13th of April 2020 and analysed by SPSS software version 16.0. Spearman correlation coefficient and Kruskal Wallis test were used to assess for associations between ABO blood group with COVID-19.
Results: The results indicated that individuals of blood group A are at increased risk of infection by SARS-CoV-2 virus and severity of COVID-19 disease. Blood groups B and O were less likely to be infected and the disease evolves less severe.
Conclusions: The results are discussed in relation to the host-parasite interactions that might contribute to susceptibility to these infections.


ABO blood group; COVID-19; SARS-CoV-2


1. Blackwell CC, Weir DM, Alkout AM, Alahmer O, Mackenzie DA, James VS, et al. Blood group phenotypes in infectious diseases. In: Bellamy R. Advances in molecular and cellular microbiology (Book 4): Susceptibility to infectious diseases. The importance of Host Genetics. Cambridge University Press 2004 309-13.
2. Mourant AE, Kopéc AC and Domaniewska-Sobczak K. Blood Groups and Diseases. London: Oxford University Press; 1978.
3. Batool Z, Durrani SH, Tariq S. Association Of Abo And Rh Blood Group Types To Hepatitis B, Hepatitis C, Hiv And Syphilis Infection, A Five Year' Experience In Healthy Blood Donors In A Tertiary Care Hospital. J Ayub Med Coll Abbottabad. 2017;29(1):90‐2.
4. Jing W, Zhao S, Liu J, Liu M. ABO blood groups and hepatitis B virus infection: a systematic review and meta-analysis. BMJ Open. 2020;10(1):e034114. doi: 10.1136/bmjopen-2019-034114.
5. Hutson AM, Atmar RL, Graham DY, Estes MK. Norwalk virus infection and disease is associated with ABO histo-blood group type. J Infect Dis. 2002;185(9):1335‐7. doi: 10.1086/339883.
6. Branch DR. Blood groups and susceptibility to virus infection: new developments. Curr Opin Hematol. 2010;17(6):558‐64. doi: 10.1097/MOH.0b013e32833ece31.
7. Lebiush M, Rannon L, Kark JD. The relationship between epidemic influenza (A(H1N1) and ABO blood group. J Hyg (Lond). 1981;87(1):139‐46. doi: 10.1017/s002217240006931x.
8. Aho K, Pyhälä R, Visakorpi R. ABO associated genetic determinant in H1N1 influenza. Tissue Antigens. 1980;16(4):310‐3. doi: 10.1111/j.1399-0039.1980.tb00311.x.
9. Naĭkhin AN, Katorgina LG, Tsaritsyna IM, Kim TN, Reznik VN, Trusov NV, et al. [Indicators of collective immunity to influenza depending on the blood group and sex of the population]. Vopr Virusol. 1989;34(4):419‐23.
10. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia
in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. doi: 10.1016/S0140-6736(20)30211-7.
11. World Health Organizatio (WHO). Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). 16–24 February 2020. Available from: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19---final-report-1100hr-28feb2020-11mar-update.pdf?sfvrsn=1a13fda0_2&download=true. (accessed April 2020).
12. Luk HKH, Li X, Fung J, Lau SKP, Woo PCY. Molecular epidemiology, evolution and phylogeny of SARS coronavirus. Infect Genet Evol. 2019;71:21‐30. doi: 10.1016/j.meegid.2019.03.001.
13. Viral Zone. Coronavirinae. Available from: https://viralzone.expasy.org/785.
14. Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270‐3. doi: 10.1038/s41586-020-2012-7.
15. Belouzard S, Chu VC, Whittaker GR. Activation of the SARS coronavirus spike protein via sequential proteolytic cleavage at two distinct sites. Proc Natl Acad Sci U S A. 2009;106(14):5871‐6. doi: 10.1073/pnas.0809524106.
16. Matsuyama S, Nagata N, Shirato K, Kawase M, Takeda M, Taguchi F. Efficient activation of the severe acute respiratory syndrome coronavirus spike protein by the transmembrane protease TMPRSS2. J Virol. 2010;84(24):12658-64. doi: 10.1128/JVI.01542-10.
17. Iwata-Yoshikawa N, Okamura T, Shimizu Y, Hasegawa H, Takeda M, Nagata N. TMPRSS2 Contributes to Virus Spread and Immunopathology in the Airways of Murine Models after Coronavirus Infection. J Virol. 2019;93(6):e01815-18. doi: 10.1128/JVI.01815-18.
18. Cheng Y, Cheng G, Chui CH, Lau FY, Chan PK, Ng MH, et al. ABO blood group and susceptibility to severe acute respiratory syndrome. JAMA. 2005;293(12):1450-1. doi: 10.1001/jama.293.12.1450-c.
19. Zhao J, Yang Y, Huang H, Li D, Gu D, Lu X, et al. Relationship between the ABO Blood Group and the COVID-19 Susceptibility. medRxiv. 2020. doi: 10.1101/2020.03.11.20031096.
20. Worldometer. About worldometer COVID-19 data. Available from: https://www.worldometers.info/coronavirus/about/ (accessed April 2020).
21. Wikipedia. ABO and Rh blood type distribution by country. Available from: https://en.wikipedia.org/wiki/Blood_type_distribution_by_country. (accessed April 2020).
22. Zietz M, Tatonetti NP. Testing the association between blood type and COVID-19 infection, intubation, and death. Preprint. medRxiv. 2020;2020.04.08.20058073. doi: 10.1101/2020.04.08.20058073.
23. Chan JF, Kok KH, Zhu Z, Chu H, To KK, Yuan S, et al. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan Emerg Microbes Infect. 2020;9(1):221‐36. doi: 10.1080/22221751.2020.1719902.
24. Kuba K, Imai Y, Rao S, Gao H, Guo F, Guan B, et al. A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus–induced lung injury. Nat Med. 2005;11(8):875-9. doi: 10.1038/nm1267.
25. Guillon P, Clément M, Sébille V, Rivain JG, Chou CF, Ruvoën-Clouet N, et al. Inhibition of the interaction between the SARS-CoV Spike protein and its cellular receptor by anti-histo-blood group antibodies. Glycobiology. 2008:18(12):1085-93. doi: 10.1093/glycob/cwn093.
26. Gérard C, Maggipinto G, Minon JM. COVID-19 and ABO blood group: another viewpoint. Br J Haematol. 2020. doi: 10.1111/bjh.16884.
27. Lakshmi Priyadarsini S, Suresh M. Factors influencing the epidemiological characteristics of pandemic COVID-19: A TISM approach. Int J Health Policy. 2020;13(2):89-98. doi: 10.1080/20479700.2020.1755804.

Submitted date:

Reviewed date:

Accepted date:

Publication date:

5ee55e530e8825751c3195f5 iberoamericanjm Articles
Links & Downloads

Iberoam J Med

Share this page
Page Sections