Blood group type A secretors are associated with a higher risk of COVID‐19 cardiovascular disease complications

  1. Tosti J. Mankelow
  2. Belinda K. Singleton
  3. Pedro L. Moura
  4. Christian J. Stevens‐Hernandez
  5. Nicola M. Cogan
  6. Gyongyver Gyorffy
  7. Sabine Kupzig
  8. Luned Nichols
  9. Claire Asby
  10. Jennifer Pooley
  11. Gabriella Ruffino
  12. Faroakh Hosseini
  13. Fiona Moghaddas
  14. Marie Attwood
  15. Alan Noel
  16. Alex Cooper
  17. David T. Arnold
  18. Fergus Hamilton
  19. Catherine Hyams
  20. Adam Finn
  21. Ashley M. Toye
  22. David J. Anstee

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Abstract

The SARS‐CoV‐2 virus causes COVID‐19, an infection capable of causing severe disease and death but which can also be asymptomatic or oligosymptomatic. We investigated whether ABO blood group or secretor status was associated with COVID‐19 severity. We investigated secretor status because expression of ABO glycans on secreted proteins and non‐erythroid cells are controlled by a fucosyltransferase (FUT2), and inactivating FUT2 mutations result in a non‐secretor phenotype which protects against some viral infections. Data combined from healthcare records and our own laboratory tests ( n  = 275) of hospitalized SARS‐CoV‐2 polymerase chain reaction positive patients confirmed higher than expected numbers of blood group A individuals compared to O (RR = 1.24, CI 95% [1.05, 1.47], p  = 0.0111). There was also a significant association between group A and COVID‐19‐related cardiovascular complications (RR = 2.56, CI 95% [1.43, 4.55], p  = 0.0011) which is independent of gender. Molecular analysis revealed that group A non‐secretors are significantly less likely to be hospitalized than secretors. Testing of convalescent plasma donors, among whom the majority displayed COVID‐19 symptoms and only a small minority required hospitalization, group A non‐secretors were slightly over‐represented. Our findings showed that group A non‐secretors are not resistant to infection by SARS‐CoV‐2, but are more likely to experience a less severe form of associated disease.

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  1. Version published to 10.1002/jha2.180
  2. ScreenIT

    SciScore for 10.1101/2020.12.19.20248172: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Epidemiological Surveillance: A retrospective cohort analysis of COVID-19 infected individuals was undertaken as part of an audit on adult patients hospitalised at North Bristol NHS Trust with COVID-19 infection, was approved by the North Bristol NHS Trust Audit and Research Ethics Committee..
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.12.19.20248172v1 on medRxiv