key: cord-0980669-h6gvl5wn
authors: Niles, Justin K.; Karnes, Hope E.; Dlott, Jeffrey S.; Kaufman, Harvey W.
title: Association of ABO/Rh with SARS‐CoV‐2 positivity: The role of race and ethnicity in a female cohort
date: 2020-10-26
journal: Am J Hematol
DOI: 10.1002/ajh.26019
sha: db79d719c24757238baad7ead87675d5c13466cf
doc_id: 980669
cord_uid: h6gvl5wn

nan

The SARS-CoV-2 positivity rate was higher in both females under 30 years of age (15.1%, 95% CI 14.9%-15.4%) and those 30-39 years (11.9%, 95% CI 11.7%-12.0%) than in females age 40 years or over (10.1%, 95% CI 9.9%-10.4%) (P < .001 for both comparisons). The most common blood type was O+ (123 642; 44.7%), followed by A+ (83 219; 30.1%); B+ (32 961; 11.9%); O-(12 871; 4.7%); A-(10 531; 3.8%); AB+ (9048; 3.3%); B-(3179; 1.2%); and AB-(1085; 0.4%).

The SARS-CoV-2 positivity rate was 38% higher in Rh+ patients (12.7%, 95% CI 12.6%-12.8%) than in Rh-patients (9.2%, 95% CI 8.9%-9.5%) (P < .001). The SARS-CoV-2 positivity rate was also significantly higher among type O patients (13.0%, 95% CI 12.8%-13.2%) than among type A (11.8%, 95% CI 11.6%-12.0%), type B (11.9%, 95% CI 11.5%-12.2%), or type AB (11.4%, 95% CI 10.7%-12.0%) patients (P < .001 for all comparisons). No statistically significant differences in SARS-CoV-2 positivity between females with type A and B (P = .66), type A and AB (P = .21), or type B and AB (P = .16) were observed. In stratified analyses, the relationship between SARS-CoV-2 positivity and Rh type remained significant across ABO blood groups ( Figure S1 ).

Among the 88 975 females with available race/ethnicity data, the distributions of ABO groups/Rh types were remarkably similar to findings from a large study of blood donors conducted by the American Red Cross. 6 In this study SARS-CoV-2 positivity rates, as well as ABO/Rh distributions, differed significantly between race/ethnicity groups (Table S1 ). Hispanic females were significantly more likely to have type O blood (58.3%) than were black non-Hispanic (49.5%), white-non-Hispanic (45.2%), and "other" race/ethnicity females (P < .001 for all comparisons). White non-Hispanic females were more than twice as likely to be Rh-(15.1%) compared to other groups, including "other" race/ethnicity (6.6%), Hispanic (6.4%), and black non-Hispanic (6.1%) groups (P < .001 for all comparisons). Hispanic females had the highest SARS-CoV-2 positivity rate (21.4%, 95% CI 20.9%-21.9%), followed by black non-Hispanic (16.3%, 95% CI 15.7%-16.9%), "other" race/ethnicity (12.8%, 95% CI 12.3%-13.4%), and white non-Hispanic (7.2%, 95% CI 6.9%-7.4%) females. I G U R E 1 Logistic regression models, associations with SARS-CoV-2 positivity. Reference Groups: 1, Rh negative; 2, Blood types A, B, and AB; 3, White non-Hispanic; 4, Age > =40 years. "LCL", lower confidence limit; "OR", odds ratio; "UCL", upper confidence limit. The bars represent the 95% Wald Confidence Limits. Multivariable adjusted model n = 88 970 of 88 975 females with race/ethnicity data (five were missing age) available (n = 88 975) still represents one of the largest known studies to date comparing the association between ABO/Rh and SARS-CoV-2 positivity. No clinical information was available to corroborate test results, correlate outcome, or assess clinical course.

In summary, an association between ABO/Rh and SARS-CoV-2 positivity was confirmed but greatly attenuated after factoring in race/ethnicity. Future studies to evaluate the influence of race/ethnicity on COVID-19 risk and clinical course are necessary for comprehensive assessment of the impact of blood group/Rh type on infection and disease. 

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. 

Genomewide association study of severe Covid-19 with respiratory failure

Blood type and outcomes in patients with COVID-19

Testing the association between blood type and COVID-19 infection, intubation, and death

SARS-CoV-2 Positivity rate for Latinos in the

Assessing differential impacts of COVID-19 on black communities

ABO and Rh(D) phenotype frequencies of different racial/ethnic groups in the United States

Numerical aspects of pontine, lateral reticular, and inferior olivary projections to two paravermal cortical zones of the cat cerebellum

ORCID Justin K. Niles https://orcid.org/0000-0002-3150-2463Harvey W. Kaufman https://orcid.org/0000-0003-2850-9047