Original title: Study of 1,775 new crown patients in Wuhan Jinyintan Hospital: Type O blood is relatively less susceptible
. Clinical observations on patients with new crown pneumonia have shown that the elderly and men are more likely to contract new crown pneumonia and develop severe illness. However, to date, there are no biomarkers that can predict an individual’s sensitivity to COVID-19. The latest research from 8 units including Southern University of Science and Technology, Shanghai Jiaotong University, Wuhan Zhongnan Hospital, Wuhan Jinyintan Hospital, etc. showed that blood types of A, B, O, and AB are associated with susceptibility to new coronary pneumonia. This is also the first study in this field.
Specifically, type O blood is relatively less susceptible to new coronary pneumonia and has a lower risk; type A blood is relatively susceptible to new coronary pneumonia and has a higher risk. The study suggests that:
(1) Type A blood may require special personal protection to reduce the chance of infection;
(2) patients with type A bloodstream infected with neocoronavirus may need to receive more monitoring and treatment;
(3) as a new crown virus treatment As part of the routine, the introduction of ABO blood types in patients and medical staff may help assess people’s level of risk exposure.
The above research is from the paper “Relationship between the ABO Blood Group and the COVID-19 Susceptibility”. The paper was published on the preprinted platform medRxiv on March 17, local time, and has not yet been peer reviewed.
The samples from the study were from three top three hospitals in Wuhan and Shenzhen, respectively: 1775 COVID-19 patients in Wuhan Jinyintan Hospital, of which 206 died; 113 patients in Wuhan University People’s Hospital; and 285 in Shenzhen Third People’s Hospital. Patients. The researchers mainly tested the ABO blood group, the incidence of neocoronary pneumonia, and the deaths in these patients. The methods used for statistical analysis are one-way ANOVA and 2-tailed chi-square test. The study also set up a random effects model (REM) to perform a meta-analysis of data from different hospitals.
Studies show that among 3694 normal people in Wuhan, the proportions of A, B, AB and O blood types were 32.16%, 24.90%, 9.10%, and 33.84%. Among the 1,775 COVID-19 patients at Wuhan Jinyintan Hospital, A, B, AB and O accounted for 37.75%, 26.42%, 10.03% and 25.80%.
It is worth noting that the proportion of blood group A and O in patients with COVID-19 was significantly higher and lower than that of normal people (P <0.001).
Wuhan University People’s Hospital and Shenzhen Third People’s Hospital, two tertiary hospitals, also observed similar ABO distribution patterns.
The analysis results showed that compared with O, B, and AB blood types, the risk of COVID-19 infection in blood group A was significantly increased (OR was 1.20; 95% confidence interval CI was 1.02-1.43, P = 0.02). Compared with A, B, AB blood types, the risk of infectious diseases of blood type O was significantly reduced (OR was 0.67; 95% CI was 0.60-0.75, P <0.001).
That is, compared with non-A blood group, people with blood group A have a significantly higher risk of acquiring COVID-19, and compared with blood group O, the risk of infection with blood group O is significantly reduced.
Previous studies have shown that the susceptibility of some viral infections is related to the ABO blood group. For example, Norwalk virus and hepatitis B have a clear blood group susceptibility. According to previous reports, individuals with blood type O are less likely to contract SARS coronavirus.
There are 8 scientific research institutions in this thesis: Southern University of Science and Technology, Shenzhen Third People ’s Hospital (Second Affiliated Hospital of Southern University of Science and Technology), Wuhan Jinyintan Hospital, Wuhan University People ’s Hospital, Chinese Academy of Medical Sciences Fuwai Hospital, East China Normal University University, Wuhan University Zhongnan Hospital, Shanghai Jiaotong University.
Corresponding author is Xing Mingzhao, the first dean and chair professor of the School of Medicine, Southern University of Science and Technology; Wang Peng, director and chair professor of the Scientific Research Office, School of Medicine, Southern University of Science and Technology; , Wang Xinghuan, director of Thunder Mountain Hospital.
Attachment: The data analysis part
of the ABO blood group of 3694 normal people in Wuhan showed that the percentage distribution of A, B, AB and O blood types were 32.16%, 24.90%, 9.10% and 33.84%, respectively, while 1775 people from Wuhan Jinyintan Hospital COVID-19 patients showed ABO distribution of blood types A, B, AB, and O were 37.75%, 26.42%, 10.03%, and 25.80%.
The proportion of COVID-19 patients with type A blood was significantly higher than the normal population, the former was 37.75%, and the latter was 32.16% (P <0.001). The proportion of patients with COVID-19 with type O blood was significantly lower than the normal population, with the former being 25.80% and the latter being 33.84% (P <0.001).
The distribution pattern of high-risk blood group A and low-risk blood group O was also observed in dead patients. Specifically, among the 206 deaths, the proportions of A, B, AB, and O blood types were 41.26%, 24.27%, 9.22%, and 25.24%, respectively. Compared with the non-O blood group, the risk of O blood death was lower, with an OR of 0.660 (95% CI 0.479-0.911, P = 0.014). In contrast, compared with the non-A group, the risk of death was higher in the A group, with an OR of 1.482 (95% CI 1.113-1.972, P = 0.008).
Next, the research team examined 113 COVID-19 patients from Wuhan University People’s Hospital, another hospital in Wuhan, and found a similar risk distribution trend for ABO blood group infections. Specifically, compared with the non-O blood group, the O blood group had a significantly lower risk of infection, with an OR of 0.644 (95% CI 0.418-0.993, P = 0.045). Compared with non-A blood group, the relative risk of A blood group is higher (OR = 1.396; 95% CI 0.952-2.048), which is higher than that of patients at Wuhan Jinyintan Hospital, although the group is related because of the relatively small sample size. Sex is not statistically significant.
The ABO blood types of 23,368 normal people in Shenzhen showed that the percentage distributions of A, B, AB and O blood types were 28.77%, 25.14%, 7.32% and 38.77%, respectively. Analysis of 285 COVID-19 patients in Shenzhen showed that the proportions of A, B, AB, and O blood types were 28.77%, 29.12%, 13.68%, and 28.42%, respectively.
Similarly, the risk of infection with blood type O was significantly reduced (OR 0.627; 95% CI 0.484-0.812). In addition, the study found an increased risk of infection with the AB blood group (OR 2.008; 95% CI 1.427-2.824). In addition, the average age of these 285 patients was 45.1 ± 18.6 years, including 147 men and 138 women. The study found no significant differences in age among patients in different ABO groups (F = 0.135; P = 0.939).
Randomized effect models show the OR estimates of the COVID-19 risk of the ABO blood group for pooled data from three hospitals. The results again showed that compared with non-A blood types, the risk of blood type A and COVID-19 was significantly increased (OR 1.21; 95% CI 1.02-1.43, P = 0.027). Compared with non-O blood type, the risk of infection was significantly reduced (OR, 0.67; 95% CI 0.60-0.75, P <0.001) blood type. Compared with other ABO blood types, blood group AB (OR, 1.48, 95% CI 0.97-2.24) and blood group B (OR, 1.09, 95% CI 0.98-1.22) also seem to have a higher risk of infection. However, the above correlation did not reach statistical significance.
Next, the research team investigated whether two risk factors, age and sex, could affect the distribution of ABO blood types in patients with COVID-19. It is known that the distribution of ABO blood types is not gender and age biased. For example, by analyzing the blood types of more than 90,000 normal people, it can be seen that the percentages of A, B, AB and O blood groups are basically the same between different age groups and genders.
Therefore, the researchers used the ABO blood group distribution of 3694 normal people in Wuhan as a control to compare with different age groups and gender groups. All patients from Wuhan Jinyintan Hospital and Wuhan People’s Hospital were merged together (1888 patients) and divided into three age groups (under 40 years old, 41-59 years old, and over 60 years old). No change between groups. Similarly, when men and women with COVID-19 were considered separately, the distribution of ABO blood types did not change much.
This study found that the ABO blood group showed different associated risks for neocoronavirus infection. Specifically, blood group A is associated with increased risk, while blood group O is associated with decreased risk, thus proving that the ABO blood group is a biomarker of COVID-19 sensitivity difference.
These findings are consistent with other coronavirus infection risk patterns similar to ABO blood types found in previous studies. For example, previous studies have shown that the susceptibility of SARS-CoV infection in Hong Kong is related to the ABO blood group.
Researchers also found that hospital staff of blood group O were less likely to be infected than those of hospitals of non blood type O. Previously, anti-A antibodies were found to specifically inhibit the adhesion of SARS-CoV S protein-expressing cells to ACE2-expressing cell lines. In view of the similarity of the nucleic acid sequence between SARS-CoV and SARS-CoV-2 and the binding similarity of the receptor angiotensin-converting enzyme 2 (ACE2), the sensitivity of type O blood is low, while type A blood is less Higher sensitivity, which is related to the presence of natural anti-blood antibodies, especially anti-A antibodies, in the blood.
The research also mentions that this hypothesis will require direct research to prove. There may be other mechanisms for the susceptibility of ABO blood group to COVID-19, which needs further research to clarify.