Associations between blood type and COVID-19 infection, intubation, and death
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Abstract
The rapid global spread of the novel coronavirus SARS-CoV-2 has strained healthcare and testing resources, making the identification and prioritization of individuals most at-risk a critical challenge. Recent evidence suggests blood type may affect risk of severe COVID-19. Here, we use observational healthcare data on 14,112 individuals tested for SARS-CoV-2 with known blood type in the New York Presbyterian (NYP) hospital system to assess the association between ABO and Rh blood types and infection, intubation, and death. We find slightly increased infection prevalence among non-O types. Risk of intubation was decreased among A and increased among AB and B types, compared with type O, while risk of death was increased for type AB and decreased for types A and B. We estimate Rh-negative blood type to have a protective effect for all three outcomes. Our results add to the growing body of evidence suggesting blood type may play a role in COVID-19.
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SciScore for 10.1101/2020.04.08.20058073: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our results are based on data collected as part of hospital care during the early course of the pandemic, where outpatient testing was severely limited due to testing capacity and supply limitations. As such, our data are highly enriched for severely-ill patients, and the absolute risk values we report are not generalizable …
SciScore for 10.1101/2020.04.08.20058073: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our results are based on data collected as part of hospital care during the early course of the pandemic, where outpatient testing was severely limited due to testing capacity and supply limitations. As such, our data are highly enriched for severely-ill patients, and the absolute risk values we report are not generalizable to all SARS-CoV-2-infected individuals. A considerable fraction of infections are mild or asymptomatic [61,62,63,64], while our data represent predominantly the most severe cases. Selection bias is a fundamental limitation of our study, so all our effect estimates are conditional on presentation to the hospital. Nonetheless, we minimized additional selection bias by making cohort criteria for cases and controls differ only with respect to the outcome of interest. Moreover, we found concordance between SARS-CoV-2-tested individuals and the general population at NYP/CUIMC in terms of blood type (Supplementary table 1). Consequently, our results are not affected by selection bias with respect to blood type, unlike some other blood type case/control study designs—particularly those using blood donors as controls, where enrichment of type O can be expected [5]. False negatives and time delay between test administrations and the return of their results both introduce noise to this analysis. We attempted to account for these biases by setting cohort entry at the time of first contact with the hospital when the patient tested positive less than 96 hours thereafter...
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.
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SciScore for 10.1101/2020.04.08.20058073: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources The manuscript was written openly on GitHub using Manubot [12]. Manubotsuggested: (Manubot, SCR_018553)Results from OddPub: Thank you for sharing your code.
About SciScore
SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert …
SciScore for 10.1101/2020.04.08.20058073: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources The manuscript was written openly on GitHub using Manubot [12]. Manubotsuggested: (Manubot, SCR_018553)Results from OddPub: Thank you for sharing your code.
About SciScore
SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.
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Our take
In a study of 1559 individuals tested for SARS-CoV-2 in New York, having blood type A was associated with higher odds of testing positive, and having blood types O or AB was associated with lower odds of testing positive; among cases, no clinical prognosis differences by blood type were observed. This study builds on findings and improves on methods from previous studies.
Study design
Case-control
Study population and setting
Observational data on 1559 individuals with known blood type who had been tested for SARS-CoV-2 were extracted from the New York Presbyterian hospital system. Associations between ABO+Rh blood type and SARS-CoV-2 with: 1) infection status, 2) intubation, and 3) death were examined, adjusting for age, sex, overweight status, diabetes, hypertension, pulmonary diseases, and …
Our take
In a study of 1559 individuals tested for SARS-CoV-2 in New York, having blood type A was associated with higher odds of testing positive, and having blood types O or AB was associated with lower odds of testing positive; among cases, no clinical prognosis differences by blood type were observed. This study builds on findings and improves on methods from previous studies.
Study design
Case-control
Study population and setting
Observational data on 1559 individuals with known blood type who had been tested for SARS-CoV-2 were extracted from the New York Presbyterian hospital system. Associations between ABO+Rh blood type and SARS-CoV-2 with: 1) infection status, 2) intubation, and 3) death were examined, adjusting for age, sex, overweight status, diabetes, hypertension, pulmonary diseases, and cardiovascular diseases.
Summary of main findings
Among the 1559 individuals tested for SARS-CoV-2, 682 tested positive. Of those who tested positive, a total of 179 were intubated and 80 died. Those in blood group A had higher odds of testing positive for SARS-CoV-2 (OR: 1.34, 95% CI [1.07-1.67], and those in blood groups O (OR: 0.80, 95% CI [0.65-0.99] and AB (OR: 0.56, 95%CI [0.31-0.97] had decreased odds of testing positive, even after adjusting for other risk factors. There were no significant differences found between blood group and the outcomes of intubation or death.
Study strengths
This study improves on methods published in previous studies by comparing those who tested positive and those who tested negative in the same population. The analyses also adjusted for other risk factors.
Limitations
These data are preliminary and cross-sectional, and it is not possible to determine whether those who were captured in this study are representative of all individuals living in New York, albeit a larger target population. The findings represent preliminary associations and should be further investigated. Larger sample sizes may be needed to examine differences between ABO+Rh group,
Value added
This is one of the few studies to investigate the association between blood type and odds of testing positive for SARS-CoV-2, and builds on results from previous studies.
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