ABO Blood Types and COVID-19: Spurious, Anecdotal, or Truly Important Relationships? A Reasoned Review of Available Data
Top Cited Papers
Open Access
- 22 January 2021
- Vol. 13 (2), 160
- https://doi.org/10.3390/v13020160
Abstract
Since the emergence of COVID-19, many publications have reported associations with ABO blood types. Despite between-study discrepancies, an overall consensus has emerged whereby blood group O appears associated with a lower risk of COVID-19, while non-O blood types appear detrimental. Two major hypotheses may explain these findings: First, natural anti-A and anti-B antibodies could be partially protective against SARS-CoV-2 virions carrying blood group antigens originating from non-O individuals. Second, O individuals are less prone to thrombosis and vascular dysfunction than non-O individuals and therefore could be at a lesser risk in case of severe lung dysfunction. Here, we review the literature on the topic in light of these hypotheses. We find that between-study variation may be explained by differences in study settings and that both mechanisms are likely at play. Moreover, as frequencies of ABO phenotypes are highly variable between populations or geographical areas, the ABO coefficient of variation, rather than the frequency of each individual phenotype is expected to determine impact of the ABO system on virus transmission. Accordingly, the ABO coefficient of variation correlates with COVID-19 prevalence. Overall, despite modest apparent risk differences between ABO subtypes, the ABO blood group system might play a major role in the COVID-19 pandemic when considered at the population level.Keywords
This publication has 106 references indexed in Scilit:
- Association between the ABO blood group and the human intestinal microbiota compositionBMC Microbiology, 2012
- Association of Variation at the ABO Locus With Circulating Levels of Soluble Intercellular Adhesion Molecule-1, Soluble P-selectin, and Soluble E-selectinCirculation: Cardiovascular Genetics, 2011
- Blood group O alleles in Native Americans: Implications in the peopling of the AmericasAmerican Journal of Physical Anthropology, 2009
- Probiotic‐associated high‐titer anti‐B in a group A platelet donor as a cause of severe hemolytic transfusion reactionsTransfusion, 2009
- Inhibition of the interaction between the SARS-CoV Spike protein and its cellular receptor by anti-histo-blood group antibodiesGlycobiology, 2008
- Evolutionary dynamics of the human ABO geneHuman Genetics, 2008
- The Galα1,3Galβ1,4GlcNAc-R (α-Gal) epitope: A carbohydrate of unique evolution and clinical relevanceBiochimica et Biophysica Acta (BBA) - General Subjects, 2008
- Evolution of the human ABO polymorphism by two complementary selective pressuresProceedings. Biological sciences, 2004
- Tissue distribution of histo‐blood group antigens.APMIS, 2000
- Blood group isoantibody stimulation in man by feeding blood group-active bacteriaJCI Insight, 1969