Impact of ABO and Rhesus Blood Groups on COVID-19 Susceptibility and Severity: A Case-control Study.

BACKGROUND: Early evidence from China suggested that blood groups may be involved in susceptibility to COVID-19. Several subsequent studies which reported controversial results. OBJECTIVES: We conducted a retrospective matched case-control study that aims to investigate the association between blood groups and the risk and/or severity of COVID-19. METHODS: We compared the blood groups distribution of 474 patients admitted to the hospital for COVID-19 between March 2020 and March 2021, to that of a positive control group of outpatients infected with COVID-19 and matched them for sex and age, as well as to the distribution in the general population. RESULTS: 318 HC+ pairs with available blood group information were matched. The proportion of group A-Rh+ in hospitalized patients (HC+) was 39.9% (CI 35.2% - 44.7%), compared to 44.8% (CI 39.8%-49.9%) and 32.3% in the positive out-patient controls (C+) and the general population (C-) respectively. Both COVID-19 positive groups (HC+ and C+) had significantly higher proportions of group A-Rh+ compared to the general population (p=0.0019 and p<0.001 respectively), indicating that group A-Rh+ increases susceptibility to COVID-19. Although blood group A-Rh+ was more frequent in the outpatients C+ compared to the hospitalized group HC+, the association did not reach statistical significance, indicating that blood group A-Rh+ is not associated with severity. There was no significant relationship between COVID-19 and other blood groups. CONCLUSION: Our findings indicate that blood group A-Rh+ increases the susceptibility for COVID-19 but is not associated with higher disease severity. This article is protected by copyright. All rights reserved.