Risk and Severity of COVID-19 and ABO Blood Group in Transcatheter Aortic Valve Patients

  1. Marion Kibler
  2. Laurent Dietrich
  3. Mohamad Kanso
  4. Adrien Carmona
  5. Benjamin Marchandot
  6. Kensuke Matsushita
  7. Antonin Trimaille
  8. Cécile How-Choong
  9. Albane Odier
  10. Gabrielle Gennesseaux
  11. Ophélie Schramm
  12. Antje Reydel
  13. Sébastien Hess
  14. Chisato Sato
  15. Sophie Caillard
  16. Laurence Jesel
  17. Olivier Morel
  18. Patrick Ohlmann

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Abstract

While cardiovascular disease has been associated with an increased risk of coronavirus disease 2019 (COVID-19), no studies have described its clinical course in patients with aortic stenosis who had undergone transcatheter aortic valve replacement (TAVR). Numerous observational studies have reported an association between the A blood group and an increased susceptibility to SARS-CoV-2 infection. Our objective was to investigate the frequency and clinical course of COVID-19 in a large sample of patients who had undergone TAVR and to determine the associations of the ABO blood group with disease occurrence and outcomes. Patients who had undergone TAVR between 2010 and 2019 were included in this study and followed-up through the recent COVID-19 outbreak. The occurrence and severity (hospitalization and/or death) of COVID-19 and their associations with the ABO blood group served as the main outcome measures. Of the 1125 patients who had undergone TAVR, 403 (36%) died before 1 January 2020, and 20 (1.8%) were lost to follow-up. The study sample therefore consisted of 702 patients. Of them, we identified 22 cases (3.1%) with COVID-19. Fourteen patients (63.6%) were hospitalized or died of disease. Multivariable analysis identified the A blood group (vs. others) as the only independent predictor of COVID-19 in patients who had undergone TAVR (odds ratio (OR) = 6.32; 95% confidence interval (CI) = 2.11−18.92; p = 0.001). The A blood group (vs. others; OR = 8.27; 95% CI = 1.83−37.43, p = 0.006) and a history of cancer (OR = 4.99; 95% CI = 1.64−15.27, p = 0.005) were significantly and independently associated with disease severity (hospitalization and/or death). We conclude that patients who have undergone TAVR frequently have a number of cardiovascular comorbidities that may work to increase the risk of COVID-19. The subgroup with the A blood group was especially prone to developing the disease and showed unfavorable outcomes.

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  1. Version published to 10.3390/jcm9113769
  2. ScreenIT

    SciScore for 10.1101/2020.06.13.20130211: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was reviewed and approved by the Institutional Review Board at the Strasbourg University Hospital (CE-2020-69).
    Consent: Owing to the retrospective nature of the study, the need for informed consent was waived.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses were performed using SPSS, version 17.0 (IBM, Armonk, NY, USA).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    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: We detected the following sentences addressing limitations in the study:
    Limitations: Several caveats of our investigation need to be considered. First, our study employed a retrospective design and the number of observed events (deaths and/or hospitalizations) was limited. As such, the presence of residual confounding may pose limitations in our ability to generalize our conclusions. Second, our research has an exploratory nature and we cannot rule out the presence of chance findings resulting from multiple comparisons. Another caveat is that the sex distribution of participants varied across the ABO blood groups. Specifically, men were underrepresented in the A blood group, potentially posing limitations in our ability to fully explore the impact of this variable on COVID-19 severity.

    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 10.1101/2020.06.13.20130211v1 on medRxiv