Associations between blood type and COVID-19 infection, intubation, and death

Evaluation of the efficacy of convalescent plasma in moderate to severe COVID-19 during 2020-2021: a retrospective observational study

Convalescent plasma therapy (CPT) is one of the treatment modalities used for COVID-19. Initial smaller studies showed the usefulness of CPT in COVID-19, but larger studies showed that it is not effective. This is a retrospective observational study conducted between 1st June 2020 and 31st July 2021 at a tertiary hospital in Noida, India. Our analysis was done on 213 COVID-19 patients, comprising 170 cases who were given convalescent plasma and 43 controls who did not get CPT. Outcomes analyzed were improvement in PaO2:FiO2 ratio (PFR) by day 5 of CPT, 28-day mortality, and level of inflammatory markers. Mean PFR before plasma transfusion was comparable between CPT and control groups (142.11±73.99 vs. 151.11±88.87, p=0.56). There was no significant difference in mean PFR after 5 days of CPT between cases and the control group (187.02±102.34 vs. 160.29±83.39, p=0.206). 28-day mortality was 47.05% in the CPT group and 37.20% in the control group (p=0.246). Mortality amongst the subgroup of patients on invasive mechanical ventilation was 89.74% in cases and 80% in controls (p=0.518). No significant difference was found in levels of serum ferritin, interleukin-6, and C-reactive protein between the two groups. Convalescent plasma does not have a significant effect on day 5 PFR and 28-day mortality. Our study could not find any subgroup of patients who would benefit from CPT. This study reinforces that CPT does not benefit moderate to severe patients with COVID-19.

Iron nutrition and COVID-19 among Nigerian healthcare workers

Background and objectives

The optimal iron hypothesis (OIH) posits that risk for infection is lowest at a mild level of iron deficiency. The extent to which this protection results from arms race dynamics in the evolution of iron acquisition and sequestration mechanisms is unclear. We evaluated the OIH with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an emerging infectious agent.

Methodology

We tested 304 healthcare workers at baseline for iron deficiency (zinc protoporphyrin:heme), anemia (hemoglobin), and SARS-CoV-2 (salivary PCR), and followed them for ~3 months with biweekly SARS-CoV-2 tests. We fit logistic regression models based on Akaike Information Criterion.

Results

Adequate data were available for 199 participants. Iron replete (OR: 2.87, 95% CI: 0.85, 9.75) and anemia (OR: 2.48; 95% CI: 0.82, 7.85) were associated with higher risk for SARS-CoV-2 infection after control for covariates. Logistic regression and Cox proportional hazards models of the SARS-CoV-2 outcome were similar. Anemia (OR: 1.81; 95% CI: 0.88, 3.71) was associated with respiratory symptoms regardless of SARS-CoV-2 infection.

Conclusions and implications

These findings provide partial support for the OIH: SARS-CoV-2 infection risk was elevated at the high end of the range of iron availability; however, the elevated risk among those with anemia was not, as expected, specific to severe iron deficiency. Narrowly, for COVID-19 epidemiology, these findings accord with evidence that SARS-CoV-2's ability to establish infection is enhanced by access to iron. More broadly, these findings suggest that the OIH does not hinge on a long history of evolutionary arms race dynamics in access to host iron.

Predictive risk models for COVID-19 patients using the multi-thresholding meta-algorithm

This study aims to develop a Machine Learning model to assess the risks faced by COVID-19 patients in a hospital setting, focusing specifically on predicting the complications leading to Intensive Care Unit (ICU) admission or mortality, which are minority classes compared to the majority class of discharged patients. We operate within a multiclass framework comprising three distinct classes, and address the challenge of dataset imbalance, a common source of model bias. To effectively manage this, we introduce the Multi-Thresholding meta-algorithm (MTh), an innovative output-level methodology that extends traditional thresholding from binary to multiclass classification. This methodology dynamically adjusts class probabilities using misclassification costs, making it highly effective in imbalanced datasets. Our approach is further enhanced by integrating the simplicity, transparency, and effectiveness of Bayesian networks to create a robust predictive model. Using patient admission data, the model accurately identifies key risk and protective factors for COVID-19 outcomes. Our findings indicate that certain patient characteristics, such as high Charlson Index and pre-existing conditions, significantly influence the risk of ICU admission and mortality. Moreover, we introduce an explanatory model that elucidates the interrelationships among these factors, demonstrating the influence of therapeutic limits on the overall risk assessment of COVID-19 patients. Overall, our research provides a significant contribution to the field of Machine Learning by offering a novel solution for multiclass classification in the context of imbalanced datasets. This model not only enhances predictive accuracy but also supports critical decision-making processes in healthcare, potentially improving patient outcomes and optimizing clinical resource allocation.

COVID-19 Is a Coronary Artery Disease Risk Equivalent and Exhibits a Genetic Interaction With ABO Blood Type

BACKGROUND

COVID-19 is associated with acute risk of major adverse cardiac events (MACE), including myocardial infarction, stroke, and mortality (all-cause). However, the duration and underlying determinants of heightened risk of cardiovascular disease and MACE post-COVID-19 are not known.

METHODS

Data from the UK Biobank was used to identify COVID-19 cases (n=10 005) who were positive for polymerase chain reaction (PCR+)-based tests for SARS-CoV-2 infection (n=8062) or received hospital-based International Classification of Diseases version-10 (ICD-10) codes for COVID-19 (n=1943) between February 1, 2020 and December 31, 2020. Population controls (n=217 730) and propensity score-matched controls (n=38 860) were also drawn from the UK Biobank during the same period. Proportional hazard models were used to evaluate COVID-19 for association with long-term (>1000 days) risk of MACE and as a coronary artery disease risk equivalent. Additional analyses examined whether COVID-19 interacted with genetic determinants to affect the risk of MACE and its components.

RESULTS

The risk of MACE was elevated in COVID-19 cases at all levels of severity (HR, 2.09 [95% CI, 1.94-2.25]; P<0.0005) and to a greater extent in cases hospitalized for COVID-19 (HR, 3.85 [95% CI, 3.51-4.24]; P<0.0005). Hospitalization for COVID-19 represented a coronary artery disease risk equivalent since incident MACE risk among cases without history of cardiovascular disease was even higher than that observed in patients with cardiovascular disease without COVID-19 (HR, 1.21 [95% CI, 1.08-1.37]; P<0.005). A significant genetic interaction was observed between the ABO locus and hospitalization for COVID-19 (Pinteraction=0.01), with risk of thrombotic events being increased in subjects with non-O blood types (HR, 1.65 [95% CI, 1.29-2.09]; P=4.8×10-5) to a greater extent than subjects with blood type O (HR, 0.96 [95% CI, 0.66-1.39]; P=0.82).

CONCLUSIONS

Hospitalization for COVID-19 represents a coronary artery disease risk equivalent, with post-acute myocardial infarction and stroke risk particularly heightened in non-O blood types. These results may have important clinical implications and represent, to our knowledge, one of the first examples of a gene-pathogen exposure interaction for thrombotic events.

Lack of association of ABO and RhD blood groups with COVID-19 mortality: A 2-center cross-sectional study in Saudi Arabia

Several diseases, including both noninfectious diseases and bacterial and viral diseases, are associated with the ABO and RH blood group systems. Previous studies have shown a link between blood type and the probability of coronavirus disease 2019 (COVID-19) infection. In this study, we aimed to explore the correlation between deaths caused by COVID-19 and ABO and RhD blood types in Saudi Arabia. In this cross-sectional observational study, data from COVID-19 patients were collected from 2 major hospitals treating COVID-19 in Riyadh City, Saudi Arabia, between March 2020 and November 2021. The association between ABO and RhD blood types and COVID-19 outcomes was investigated. A total of 2302 real-time polymerase chain reaction-confirmed COVID-19 patients were enrolled in this study; a chi-square test was used to determine the statistical significance of the data. Of the 2302 enrolled patients, 1008 (43.8%) had blood type O, 677 (29.41%) had blood type A, 502 (21.8%) had blood type B, and 115 (5%) had blood type AB. Of the patients, 2143 (93.1%) were RhD-positive. The O-positive blood type had the highest mortality rate among COVID-19-infected patients, whereas the AB-negative type had the lowest. However, statistical analysis revealed no significant correlation between blood type (ABO or RhD) and COVID-19-based susceptibility or mortality. In conclusion, we found no association between ABO and RhD blood types and either susceptibility to or mortality due to COVID-19 in Saudi Arabia.

Postinfectious Pulmonary Complications: Establishing Research Priorities to Advance the Field: An Official American Thoracic Society Workshop Report

Continued improvements in the treatment of pulmonary infections have paradoxically resulted in a growing challenge of individuals with postinfectious pulmonary complications (PIPCs). PIPCs have been long recognized after tuberculosis, but recent experiences such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have underscored the importance of PIPCs following other lower respiratory tract infections. Independent of the causative pathogen, most available studies of pulmonary infections focus on short-term outcomes rather than long-term morbidity among survivors. In this document, we establish a conceptual scope for PIPCs with discussion of globally significant pulmonary pathogens and an examination of how these pathogens can damage different components of the lung, resulting in a spectrum of PIPCs. We also review potential mechanisms for the transition from acute infection to PIPC, including the interplay between pathogen-mediated injury and aberrant host responses, which together result in PIPCs. Finally, we identify cross-cutting research priorities for the field to facilitate future studies to establish the incidence of PIPCs, define common mechanisms, identify therapeutic strategies, and ultimately reduce the burden of morbidity in survivors of pulmonary infections.

UKB.COVID19: an R package for UK Biobank COVID-19 data processing and analysis

COVID-19 caused by SARS-CoV-2 has resulted in a global pandemic with a rapidly developing global health and economic crisis. Variations in the disease have been observed and have been associated with the genomic sequence of either the human host or the pathogen. Worldwide scientists scrambled initially to recruit patient cohorts to try and identify risk factors. A resource that presented itself early on was the UK Biobank (UKBB), which is investigating the respective contributions of genetic predisposition and environmental exposure to the development of disease. To enable COVID-19 studies, UKBB is now receiving COVID-19 test data for their participants every two weeks. In addition, UKBB is delivering more frequent updates of death and hospital inpatient data (including critical care admissions) on the UKBB Data Portal. This frequently changing dataset requires a tool that can rapidly process and analyse up-to-date data. We developed an R package specifically for the UKBB COVID-19 data, which summarises COVID-19 test results, performs association tests between COVID-19 susceptibility/severity and potential risk factors such as age, sex, blood type, comorbidities and generates input files for genome-wide association studies (GWAS). By applying the R package to data released in April 2021, we found that age, body mass index, socioeconomic status and smoking are positively associated with COVID-19 susceptibility, severity, and mortality. Males are at a higher risk of COVID-19 infection than females. People staying in aged care homes have a higher chance of being exposed to SARS-CoV-2. By performing GWAS, we replicated the 3p21.31 genetic finding for COVID-19 susceptibility and severity. The ability to iteratively perform such analyses is highly relevant since the UKBB data is updated frequently. As a caveat, users must arrange their own access to the UKBB data to use the R package.

Association Between Rhesus and ABO Blood Group Types and Their Impact on Clinical Outcomes in Critically Ill Patients with COVID-19: A Multi-Center Investigation

Background

There is increasing evidence suggesting that ABO blood type may play a role in the immunopathogenesis of COVID-19 infection. In addition to ABO blood type, the Rhesus (Rh) factor has also been implicated in various disease processes. Therefore, our study aimed to assess the association between both ABO and Rh blood types in critically ill patients with COVID-19 and their clinical outcomes.

Methods

A multicenter retrospective cohort study conducted in Saudi Arabia between March 1, 2020, and July 31, 2021, involving adult COVID-19 patients admitted to Intensive Care Units, aimed to explore potential associations between rhesus blood group types (Positive versus Negative) and clinical outcomes. The primary endpoint assessed was the hospital length of stay (LOS). Other endpoints were considered secondary.

Results

After propensity score matching (3:1 ratio), 212 patients were included in the final analysis. The hospital length of stay was longer in a negative Rh blood group compared with patients in the Rh-positive group (beta coefficient 0.26 (0.02, 0.51), p = 0.03). However, neither 30-day mortality (HR 0.28; 95% CI 0.47, 1.25, p = 0.28) nor in-hospital mortality (HR 0.74; 95% CI 0.48, 1.14, p = 0.17) reached statistical significance. Additionally, among the different ABO types, the A+ blood group exhibited a higher proportion of thrombosis/infarction and in-hospital mortality (28.1% and 31.2%, respectively).

Conclusion

This study highlights the potential impact of blood group type on the prognosis of critically ill patients with COVID-19. It has been observed that patients with a negative Rh blood group type tend to have a longer hospital stay, while their mortality rates and complications during ICU stay are similar to the patients with a Rh-positive group.

Relationship between blood group (ABO) and risk of COVID-19 infection in a patient cohort in Tehran, Iran

Background and purpose. Coronavirus (COVID-19) is a contagious disease causing severe acute respiratory syndrome which had a catastrophic effect on the world population and resulted in more than 2.9 million deaths worldwide. Epidemiological investigations have recently announced blood type has an association with the incidence of COVID-19 infection. Consequently, research in this regard can be effective in determining a person's susceptibility to a viral infection. Therefore, we investigated the relationship between blood types and the risk of COVID-19 in patients admitted to Khorshid laboratory, Tehran, Iran. Materials and methods. From January to March 2020, 50 nasal and throat swapb samples of patients' secretions were obtained from patients who were admitted to Khorshid laboratory. They were confirmed to have COVID-19 virus RNA and real-time polymerase chain reaction (PCR)-ABI, and their blood type was determined simultaneously. After collecting data to determine the relationship between COVID-19 infection and blood type, a confidence interval of 90 % was considered using SPSS 16. Results. The mean age of the patients was measured at 38.4±6.3 years. According to PCR results, 100 % of the subjects with COVID-19 showed blood type A. In addition, the ratio of blood type A to the percentage of reference type O was higher (P=0.009). Conclusion. There was a significant relationship between ABO blood type and susceptibility to COVID-19. As the current study suggests, those with blood type A are at a higher COVID-19 infection risk than those with blood type O.

Assessment of the COVID-19 pandemic progression in Ecuador through seroprevalence analysis of anti-SARS-CoV-2 IgG/IgM antibodies in blood donors

Introduction

Coronavirus Disease 2019 (COVID-19) is a severe respiratory illness caused by the RNA virus SARS-CoV-2. Globally, there have been over 759.4 million cases and 6.74 million deaths, while Ecuador has reported more than 1.06 million cases and 35.9 thousand deaths. To describe the COVID-19 pandemic impact and the vaccinations effectiveness in a low-income country like Ecuador, we aim to assess the seroprevalence of IgG and IgM antibodies against SARS-CoV-2 in a sample from healthy blood donors at the Cruz Roja Ecuatoriana.

Methods

The present seroprevalence study used a lateral flow immunoassay (LFIA) to detect anti-SARS-CoV-2 IgG and IgM antibodies in months with the highest confirmed case rates (May 2020; January, April 2021; January, February, June, July 2022) and months with the highest vaccination rates (May, June, July, August, December 2021) in Quito, Ecuador. The IgG and IgM seroprevalence were also assessed based on sex, age range, blood type and RhD antigen type. The sample size was 8,159, and sampling was performed based on the availability of each blood type.

Results

The results showed an overall IgG and IgM seroprevalence of 47.76% and 3.44%, respectively. There were no differences in IgG and IgM seroprevalences between blood groups and sex, whereas statistical differences were found based on months, age range groups, and RhD antigen type. For instance, the highest IgG seroprevalence was observed in February 2022 and within the 17-26 years age range group, while the highest IgM seroprevalence was in April 2021 and within the 47-56 years age range group. Lastly, only IgG seroprevalence was higher in RhD+ individuals while IgM seroprevalence was similar across RhD types.

Discussion

This project contributes to limited data on IgG and IgM antibodies against SARS-CoV-2 in Ecuador. It suggests that herd immunity may have been achieved in the last evaluated months, and highlights a potential link between the RhD antigen type and COVID-19 susceptibility. These findings have implications for public health strategies and vaccine distribution not only in Ecuador but also in regions with similar characteristics.

More evidence for widespread antagonistic pleiotropy in polymorphic disease alleles

Introduction

Many loci segregate alleles classified as "genetic diseases" due to their deleterious effects on health. However, some disease alleles have been reported to show beneficial effects under certain conditions or in certain populations. The beneficial effects of these antagonistically pleiotropic alleles may explain their continued prevalence, but the degree to which antagonistic pleiotropy is common or rare is unresolved. We surveyed the medical literature to identify examples of antagonistic pleiotropy to help determine whether antagonistic pleiotropy appears to be rare or common.

Results

We identified ten examples of loci with polymorphisms for which the presence of antagonistic pleiotropy is well supported by detailed genetic or epidemiological information in humans. One additional locus was identified for which the supporting evidence comes from animal studies. These examples complement over 20 others reported in other reviews.

Discussion

The existence of more than 30 identified antagonistically pleiotropic human disease alleles suggests that this phenomenon may be widespread. This poses important implications for both our understanding of human evolutionary genetics and our approaches to clinical treatment and disease prevention, especially therapies based on genetic modification.

Narrative Review Explaining the Role of HLA-A, -B, and -C Molecules in COVID-19 Disease in and around Africa

The coronavirus disease 2019 (COVID-19) has left a devasting effect on various regions globally. Africa has exceptionally high rates of other infectious diseases, such as tuberculosis (TB), human immunodeficiency virus (HIV), and malaria, and was not impacted by COVID-19 to the extent of other continents Globally, COVID-19 has caused approximately 7 million deaths and 700 million infections thus far. COVID-19 disease severity and susceptibility vary among individuals and populations, which could be attributed to various factors, including the viral strain, host genetics, environment, lifespan, and co-existing conditions. Host genetics play a substantial part in COVID-19 disease severity among individuals. Human leukocyte antigen (HLA) was previously been shown to be very important across host immune responses against viruses. HLA has been a widely studied gene region for various disease associations that have been identified. HLA proteins present peptides to the cytotoxic lymphocytes, which causes an immune response to kill infected cells. The HLA molecule serves as the central region for infectious disease association; therefore, we expect HLA disease association with COVID-19. Therefore, in this narrative review, we look at the HLA gene region, particularly, HLA class I, to understand its role in COVID-19 disease.

Blood groups and Rhesus status as potential predictors of outcomes in patients with cardiac resynchronisation therapy

Cardiac resynchronisation therapy (CRT) improves prognosis in patients with heart failure (HF) however the role of ABO blood groups and Rhesus factor are poorly understood. We hypothesise that blood groups may influence clinical and survival outcomes in HF patients undergoing CRT. A total of 499 patients with HF who fulfilled the criteria for CRT implantation were included. Primary outcome of all-cause mortality and/or heart transplant/left ventricular assist device was assessed over a median follow-up of 4.6 years (IQR 2.3-7.5). Online repositories were searched to provide biological context to the identified associations. Patients were divided into blood (O, A, B, and AB) and Rhesus factor (Rh-positive and Rh-negative) groups. Mean patient age was 66.4 ± 12.8 years with a left ventricular ejection fraction of 29 ± 11%. There were no baseline differences in age, gender, and cardioprotective medication. In a Cox proportional hazard multivariate model, only Rh-negative blood group was associated with a significant survival benefit (HR 0.68 [0.47-0.98], p = 0.040). No association was observed for the ABO blood group (HR 0.97 [0.76-1.23], p = 0.778). No significant interaction was observed with prevention, disease aetiology, and presence of defibrillator. Rhesus-related genes were associated with erythrocyte and platelet function, and cholesterol and glycated haemoglobin levels. Four drugs under development targeting RHD were identified (Rozrolimupab, Roledumab, Atorolimumab, and Morolimumab). Rhesus blood type was associated with better survival in HF patients with CRT. Further research into Rhesus-associated pathways and related drugs, namely whether there is a cardiac signal, is required.

Lewis a-b- histo-blood group antigen phenotype is predictive of severe COVID-19 in the black South African population group

Several risk factors have been associated with SARS-CoV-2 infections and severity of COVID-19 disease it causes. This study investigated whether variations in histo-blood group antigen (HBGA) expression can predispose individuals to SARS-CoV-2 infections and severity of the disease. Nasopharyngeal swabs, randomly selected from SARS-CoV-2 positive and SARS-CoV-2 negative individuals, were tested for Lewis and H-type 1 HBGA phenotypes by ELISA using monoclonal antibodies specific to Lewis a, Lewis b and H type 1 antigens. The most common Lewis HBGA phenotype among all study participants was Lewis a-b+ (46%), followed by Lewis a-b- (24%), Lewis a+b- and Lewis a+b+ (15% each), while 55% of the study participants were H-type 1. Although SARS-CoV-2 negative individuals had a lower likelihood of having a Lewis a-b- phenotype compared to their SARS-CoV-2 positives counterparts (OR: 0.53, 95% C.I: 0.255-1.113), it did not reach statistical significance (P = 0.055). The frequency of Lewis a+b+, Lewis a+B-, Lewis a-b+, H type 1 positive and H type 1 negative were consistent between SARS-CoV-2 positive and SARS-CoV-2 negative individuals. When stratified according to severity of the disease, individuals with Lewis a+b- phenotype had a higher likelihood of developing mild COVID-19 symptoms (OR: 3.27, 95% CI; 0.9604-11.1), but was not statistically significant (P = 0.055), while Lewis a-b- phenotype was predictive of severe COVID-19 symptoms (OR: 4.3, 95% CI: 1.274-14.81), P = 0.016. In conclusion, individuals with Lewis a-b- phenotype were less likely to be infected by SARS-CoV-2, but when infected, they were at risk of severe COVID-19.

The impact of ABO blood types on humoral immunity responses and antibody persistency after different COVID-19 vaccine regimens

This study evaluated the possible effects of blood types on coronavirus disease (COVID-19) vaccine immunogenicity and antibody (Ab) persistency. Five different vaccinated groups against COVID-19 were investigated at Pasteur Institute of Iran from April 2021 to December 2022. Anti-Spike IgG and neutralizing Ab rise were tracked on Day 21 as well as the humoral immune persistency assessment 180 after booster shots. Late adverse events up to 6 months after the booster dose were collected. The results showed that blood type A, led to a significantly higher anti-Spike Ab rise in AstraZeneca primed recipients in comparison with Sinopharm primed ones in heterologous regimens (p: 0.019). Furthermore, blood type O was a great co-effector in homologous AstraZeneca recipients regarding neutralizing Ab rise (0.013). In addition, blood type O led to a better anti-Spike Ab persistency in the Sinopharm homologous group whereas type A had the best effect on neutralizing Ab durability in the same vaccine group. What is more, Rh-positive individuals in AstraZeneca + PastoCovac Plus group had a higher rate of anti-Spike Ab rise (p = 0.001). Neutralizing Ab rise was also induced in AstraZeneca homologous and heterologous regimens of Rh-positive individuals significantly higher than Sinopharm primed cases. The present study showed the potential impact of blood types A/O and Rh-positive on a better humoral immune responses and Ab persistency. It is proposed that blood type A and Rh-positive could increase the Ab rise in AstraZeneca vaccinated individuals. Moreover, blood type O might be a better co-effector of anti-Spike Ab persistency in Sinopharm recipients.

Association of ABO blood group, Rh phenotype and MN blood group with susceptibility to COVID-19

BACKGROUND

Previous studies have reported that the susceptibility to coronavirus disease 2019 (COVID-19) is related to ABO blood group, but the relationship with Rh phenotype and MN blood group is unknown. China had adopted a strict control policy on COVID-19 until December 5, 2022, when local communities were liberalized. Therefore, we aimed to explore the correlation between ABO blood group, Rh phenotype, MN blood group and susceptibility to COVID-19 based on the time sequence of infection during the pandemic.

METHODS

A total of 870 patients who were routinely hospitalized in Ningbo Medical Center Lihuili Hospital from March 1, 2023 to March 31, 2023 were randomly selected to enroll in this study. Patients were divided into susceptible group and non-susceptible group, according to the time of their previous infection. The demographics and clinical information of the enrolled participants were collected from electronic medical records. The association of ABO blood group, Rh phenotype and MN blood group with susceptibility to COVID-19 was analyzed.

RESULTS

A total of 650 cases (74.7%) had been infected with COVID-19, with 157 cases (18.0%) in the second week and 252 cases (29.0%) in the third week, reaching the peak of infection. Compared with the non-susceptible group, the susceptible group had no statistically significant differences in ABO blood group and Rh phenotype, but the proportion of N+ was higher (75.6% vs 68.9%, P = 0.030) and the proportion of MM was lower (24.4% vs 31.1%, P = 0.030). Consistent with this, ABO blood group and Rh phenotype were not significantly associated with susceptibility to COVID-19 (P>0.05), while N+ and MM were associated with susceptibility to COVID-19 (OR: 1.432, 95% confidence interval [CI]: 1.049, 1.954, P = 0.024; OR: 0.698, 95% CI: 0.512, 0.953, P = 0.024, respectively), after adjusting for age, sex, BMI, basic disease, and vaccination status in multivariate logistic regression analysis.

CONCLUSION

Our study showed that ABO blood group and Rh phenotype may not be related to the susceptibility to COVID-19, but MN blood group may be associated with the susceptibility to COVID-19.

Immunology of SARS-CoV-2 Infection

According to the data from the World Health Organization, about 800 million of the world population had contracted coronavirus infection caused by SARS-CoV-2 by mid-2023. Properties of this virus have allowed it to circulate in the human population for a long time, evolving defense mechanisms against the host immune system. Severity of the disease depends largely on the degree of activation of the systemic immune response, including overstimulation of macrophages and monocytes, cytokine production, and triggering of adaptive T- and B-cell responses, while SARS-CoV-2 evades the immune system actions. In this review, we discuss immune responses triggered in response to the SARS-CoV-2 virus entry into the cell and malfunctions of the immune system that lead to the development of severe disease.

Distribution of Genetic Factors Associated with Severe COVID-19 in Ethnic Groups of the Eastern Caucasus

Background. Previously, genetic markers rs11385942 G>GA and rs657152 C>A of disease severity were identified for COVID-19. The study of the prevalence of clinically significant genetic markers may be useful for the development of region-specific approaches to disease control, considering, among other things, the ethnic composition of the territory, which is especially relevant for Russia. Based on the ethnic heterogeneity of the population of the Republic of Dagestan, this region was chosen as an example to study the distribution of COVID-19 severity markers of interest. Objective. Investigation of the prevalence of rs11385942 G>GA and rs657152 C>A markers among five ethnic groups residing in Dagestan. Methods. The study included 605 healthy volunteers (158 men and 447 women) from five different autochthonous ethnic groups living in the Republic of Dagestan: 118 Avars, 121 Dargins, 116 Laks, 127 Kumyks, and 123 Lezgins. Blood served as a material for determining polymorphisms. Carriage of polymorphic markers was determined by real-time polymerase chain reaction method. Results. The prevalence of rs11385942 G>GA marker ranges from 10.17% among Avars to 15.04% among Lezgins; significant differences were found in comparison with Russian ethnic group from literature sources. The second marker – rs657152 A>C — is distributed relatively homogeneously in the studied groups, without significant differences, and correlates with the data on the frequency of marker detection among Russians, as well as among European populations and worldwide — 50–60%. Conclusion. No differences were found within the ethnic groups of Dagestan in the carriage of both studied COVID-19 severity markers. At the same time, the rs11385942 G>GA marker detection frequency in the analyzed groups was on average higher in comparison with Russians and the average values for European populations.

COVID-19 in a Portuguese whole blood donor population

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), leading to pneumonia and acute respiratory distress syndrome. The COVID-19 pandemic had a major impact on the stock of blood banks worldwide. This study aims to assess the prevalence of COVID-19 in a population of whole blood donors and analyze the possible association between blood group and susceptibility to the disease and the impact of adopting preventive measures against SARS-CoV-2 infection. Material and methods: This retrospective study included all whole blood donors from a Portuguese hospital between July and September 2021. A self-assessment questionnaire was used to collect data on COVID-19 infection, vaccination, and preventive measures. Statistical analysis was performed using Chi-square and Mann-Whitney U tests. Results: The prevalence of COVID-19 in the donor population was 11.96% (n = 97), with only 2 cases of serious illness requiring hospitalization. No association was found between blood group and disease susceptibility. Older men were less likely to adopt preventive measures. The vaccination rate was high, with 84.26% of donors having received at least one dose of the vaccine. Seven donors declined COVID-19 vaccination. Preventive measures did not differ based on COVID-19 infection status or vaccination. Discussion: Although there was a higher frequency of COVID-19 in group A donors, the blood group was not associated with susceptibility to infection. The donor population consisted of young individuals without comorbidities, showing a COVID-19 prevalence like the general population and few severe cases. The high vaccination rate and adoption of preventive measures likely contributed to these findings.

Association between ABO blood group/genotype and COVID-19 in a Japanese population

An association between coronavirus disease 2019 (COVID-19) and the ABO blood group has been reported. However, such an association has not been studied in the Japanese population on a large scale. Little is known about the association between COVID-19 and ABO genotype. This study investigated the association between COVID-19 and ABO blood group/genotype in a large Japanese population. All Japanese patients diagnosed with COVID-19 were recruited through the Japan COVID-19 Task Force between February 2020 and October 2021. We conducted a retrospective cohort study involving 1790 Japanese COVID-19 patients whose DNA was used for a genome-wide association study. We compared the ABO blood group/genotype in a healthy population (n = 611, control) and COVID-19 patients and then analyzed their associations and clinical outcomes. Blood group A was significantly more prevalent (41.6% vs. 36.8%; P = 0.038), and group O was significantly less prevalent (26.2% vs. 30.8%; P = 0.028) in the COVID-19 group than in the control group. Moreover, genotype OO was significantly less common in the COVID-19 group. Furthermore, blood group AB was identified as an independent risk factor for most severe diseases compared with blood group O [aOR (95% CI) = 1.84 (1.00-3.37)]. In ABO genotype analysis, only genotype AB was an independent risk factor for most severe diseases compared with genotype OO. Blood group O is protective, whereas group A is associated with the risk of infection. Moreover, blood group AB is associated with the risk of the "most" severe disease.

Rhesus factor is a stronger predictor for the risk of Sars-CoV-2 and mortality than ABO blood types

Objectives

In this study, we aimed to evaluate the relationship between ABO blood groups and Rhesus factor (Rf) and severe acute respiratory syndrome coronavirus-2 (Sars-CoV-2), as well as the risk of infection susceptibility and death according to pre-existing comorbidities.

Methods

This retrospective study included patients medical record between March 2020 and March 2021. A total 470 patients were included in the study. The subjects were categorized according to diagnose of Sars-CoV-2. Also, we evaluated the subject according to severity of Sars-CoV-2 infection. The logistic and multivariate regression analysis were performed to predict possible effect of ABO and Rf types as well as comorbidities on indicators of Sars-CoV-2 severity including Intensive care unit (ICU) hospitalization, intubation, and mortality.

Results

The distribution of ABO blood type and Rf were not statistically different cases with and without Sars-CoV-2. Blood type B and A were the most groups in intubation and mortality among patients with Sars-CoV-2. However, ABO blood types had no significant effect on risk of Sars-CoV-2 and mortality while, Rf had a significantly effect on it. Additionally, Rf had a statistically significant effect on all severity indicators of Sars-CoV-2 but ABO had not.

Conclusions

While Rf was significantly associated with risk of Sars-CoV-2 and had a strong effect on ICU admission, intubation, and mortality, ABO groups were not associated with risk of disease. Intubation and mortality rates were higher in patients with blood group B (OR: 2.93 p:0.390 95 % CI [0.253–33.9], OR: 0.217 p:0.211 95 % CI [0.020–2.37]) and Rh factor + (OR: 1.63 p:0.027 95 % CI [0.046–0.828]).

Correlation between ABO blood type, susceptibility to SARS-CoV-2 infection and COVID-19 disease severity: A systematic review

OBJECTIVES

To verify the association between the ABO blood type and the risk of SARS-CoV-2 infection and COVID-19 disease severity.

METHODS

This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using the 2020 PRISMA Checklist and flow diagram, and articles selected for review were analyzed using the Newcastle-Ottawa Quality Rating Scale. The research question was: "Would the ABO blood group influence the risk of infection and clinical course of patients infected with SARS-CoV-2?", The following databases were used: Embase, PubMed, Virtual Health Library (VHL), Web of Science, ScienceDirect and Scopus. The protocol for this review was registered in the Prospective Register of Systematic Reviews (PROSPERO), number CRD42021245945.

RESULTS

We found 798 articles across PubMed, Embase, Scopus, Web of Science, Science Direct and Virtual Health Library and 54 articles were included in the final analysis. Among 30 studies evaluating the risk of COVID-19 infection, 21 found significant correlations with ABO blood groups, 14 of them revealing an increased risk in blood group A and 15 studies showing a decreased risk in blood group O. Most studies found no significant correlation with disease severity or mortality.

CONCLUSION

The qualitative assessment of available information suggests that blood group A may be a risk factor for COVID-19 infection and that blood group O may have a protective effect. We were unable to determine a clear association between the ABO blood group and mortality. These conclusions are based on highly heterogenous evidence.

Association between ABO blood groups and SARS-CoV-2 infection in blood donors of Puglia region

This is an observational multicentric cross-sectional study aiming at assessing the association between ABO blood groups and SARS-CoV-2 seroprevalence among the blood donors in Puglia region. Data on ABO and Rh blood groups and demographic characteristics were obtained from Blood Bank Information System. All donors were screened for SARS-CoV-2 IgG antibodies. Comparison of seroprevalence among blood groups and the association between the recorded variables and seroprevalence were evaluated. A total of 35,709 donors from 22 centers were included, with a seroprevalence of 6.8%. The distribution of ABO phenotypes was blood type O (46.8%), A (34.0%), B (14.7%), and AB (4.5%). Among the 2416 donors reactive for SARS-CoV-2 IgG, the prevalent phenotype was blood type O (43.1%), followed by A (37.7%), B (14.2%), and AB (5%). The seroprevalence of phenotype A and AB was 7.5%, followed by B (6.5%) and O (6.2%). According to the adjusted analysis, there was an increase in seroprevalence in groups A and AB, compared to group O, and an increase in males compared to females. A possible effect modification was observed after stratifying for sex (p = 0.0515). A significantly lower prevalence of blood type O was found compared to A and AB, whereas no association was observed between Rh factor and seroprevalence. We hypothesized that the A antigen present in blood type A and AB can play a role in the binding of SARS-CoV-2 to ACE2 receptors, resulting in an increased risk of infection. Furthermore, natural anti-A/anti-B antibodies produced in group O could block viral adhesion to cells and explain a lower risk of infection.

ABO blood group and rhesus factor association with inpatient COVID-19 mortality and severity: a two-year retrospective review

Background

Early reports have indicated a relationship between ABO and rhesus blood group types and infection with SARS-CoV-2. We aim to examine blood group type associations with COVID-19 mortality and disease severity.

Methods

This is a retrospective chart review of patients ages 18 years or older admitted to the hospital with COVID-19 between January 2020 and December 2021. The primary outcome was COVID-19 mortality with respect to ABO blood group type. The secondary outcomes were 1. Severity of COVID-19 with respect to ABO blood group type, and 2. Rhesus factor association with COVID-19 mortality and disease severity. Disease severity was defined by degree of supplemental oxygen requirements (ambient air, low-flow, high-flow, non-invasive mechanical ventilation, and invasive mechanical ventilation).

Results

The blood type was collected on 596 patients with more than half (54%, N=322) being O+. The ABO blood type alone was not statistically associated with mortality (P=0.405), while the RH blood type was statistically associated with mortality (P<0.001). There was statistically significant association between combined ABO and RH blood type and mortality (P=0.014). Out of the mortality group, the O+ group had the highest mortality (52.3%), followed by A+ (22.8%). The combined ABO and RH blood type was statistically significantly associated with degree of supplemental oxygen requirements (P=0.005). The Kaplan-Meier curve demonstrated that Rh- patients had increased mortality.

Conclusion

ABO blood type is not associated with COVID-19 severity and mortality. Rhesus factor status is associated with COVID-19 severity and mortality. Rhesus negative patients were associated with increased mortality risk.

Time-sensitive testing pressures and COVID-19 outcomes: are socioeconomic inequalities over the first year of the pandemic explained by selection bias?

BACKGROUND

There are many ways in which selection bias might impact COVID-19 research. Here we focus on selection for receiving a polymerase-chain-reaction (PCR) SARS-CoV-2 test and how known changes to selection pressures over time may bias research into COVID-19 infection.

METHODS

Using UK Biobank (N = 420,231; 55% female; mean age = 66.8 [SD = 8·11]) we estimate the association between socio-economic position (SEP) and (i) being tested for SARS-CoV-2 infection versus not being tested (ii) testing positive for SARS-CoV-2 infection versus testing negative and (iii) testing negative for SARS-CoV-2 infection versus not being tested. We construct four distinct time-periods between March 2020 and March 2021, representing distinct periods of testing pressures and lockdown restrictions and specify both time-stratified and combined models for each outcome. We explore potential selection bias by examining associations with positive and negative control exposures.

RESULTS

The association between more disadvantaged SEP and receiving a SARS-CoV-2 test attenuated over time. Compared to individuals with a degree, individuals whose highest educational qualification was a GCSE or equivalent had an OR of 1·27 (95% CI: 1·18 to 1·37) in March-May 2020 and 1·13 (95% CI: 1.·10 to 1·16) in January-March 2021. The magnitude of the association between educational attainment and testing positive for SARS-CoV-2 infection increased over the same period. For the equivalent comparison, the OR for testing positive increased from 1·25 (95% CI: 1·04 to 1·47), to 1·69 (95% CI: 1·55 to 1·83). We found little evidence of an association between control exposures, and any considered outcome.

CONCLUSIONS

The association between SEP and SARS-CoV-2 testing changed over time, highlighting the potential of time-specific selection pressures to bias analyses of COVID-19. Positive and negative control analyses suggest that changes in the association between SEP and SARS-CoV-2 infection over time likely reflect true increases in socioeconomic inequalities.

Association of ABO Blood Type with Infection and Severity of COVID-19 in Inpatient and Longitudinal Cohorts

The objectives of this study were to (1) investigate the association between human blood type and COVID-19 in both inpatient and longitudinal populations and (2) identify the association between blood type and severity of COVID-19 via presence of cellular biomarkers of severe infection in hospitalized individuals at our institution in South Florida. This study consisted of (1) a single-center retrospective analysis of 669 out of 2741 COVID-19-positive, screened patients seen from 1 January 2020 until 31 March 2021 at the University of Miami Emergency Department (ED) who tested positive for COVID-19 and had a documented ABO blood type and (2) a longitudinal SARS-CoV-2 immunity study (“CITY”) at the University of Miami Miller School of Medicine, consisting of 185 survey participants. In an inpatient setting, blood type appeared to be associated with COVID-19 severity and mortality. Blood type O sustained less risk of COVID-19 mortality, and blood type O- demonstrated less risk of developing COVID-19 pneumonia. Inpatients with O- blood type exhibited less biomarkers of severe infection than did other blood types. In a longitudinal setting, there was no association found between blood type and SARS-CoV-2 infection.

Impact of ABO Blood Group, Hematological, and Biochemical Abnormalities on Incidence of Patients Infected with COVID-19

This study aimed to investigate the relationship between blood types and COVID-19 susceptibility and explore changes in blood variables, as well as their relationship with the occurrence of COVID-19. SARS-CoV-2 is a pandemic that has affected people's health and the global financial system. Since the initial confirmed case of COVID-19, people have been influenced worldwide with varying manifestations. Moreover, researchers have illustrated a link between ABO blood types and COVID-19 susceptibility and incidence. Research has also shown that ABO blood groups might play a role in estimating COVID-19 susceptibility and death. Our analysis revealed that blood type O might probably reduce vulnerability to the SARS-CoV-2 illness. On the contrary, people with blood type A are at a higher risk of SARS-CoV-2 infection. This study also evaluated liver biomarkers among COVID-19 patients, revealing significant abnormalities in the levels of alanine amino transferees, aspartate amino transferees, gamma-glutamyl transferees, and total bilirubin.

Systems-level profiling of early peripheral host-response landscape variations across COVID-19 severity states in an Indian cohort

Host immune response to COVID-19 plays a significant role in regulating disease severity. Although big data analysis has provided significant insights into the host biology of COVID-19 across the world, very few such studies have been performed in the Indian population. This study utilizes a transcriptome-integrated network analysis approach to compare the immune responses between asymptomatic or mild and moderate-severe COVID-19 patients in an Indian cohort. An immune suppression phenotype is observed in the early stages of moderate-severe COVID-19 manifestation. A number of pathways are identified that play crucial roles in the host control of the disease such as the type I interferon response and classical complement pathway which show different activity levels across the severity spectrum. This study also identifies two transcription factors, IRF7 and ESR1, to be important in regulating the severity of COVID-19. Overall this study provides a deep understanding of the peripheral immune landscape in the COVID-19 severity spectrum in the Indian genetic background and opens up future research avenues to compare immune responses across global populations.

Predictive value of ferritin, glucose, urea, and creatinine for COVID-19 severity and mortality in patients from Asir, Saudi Arabia

OBJECTIVES

To correlate demographics, blood groupings, and laboratory characteristics of hospitalized COVID-19 patients with disease severity and outcomes.

METHODS

This study included 294 COVID-19 patients. Data on patient age, gender, laboratory results, clinical severity, mortality, comorbidities, and blood group were obtained from medical records retrospectively.

RESULTS

High levels of ferritin (p<0.01), urea (p<0.0001), and creatinine (p<0.05) were detected in intensive care unit (ICU)-admitted patients. Ferritin (p<0.05), glucose (p<0.0001), urea (p<0.0001), and creatinine (p<0.0001) were significantly higher in non-survivor compared to survivor COVID-19 patients. Predictors for ICU admission among patients were ferritin (odd ratio [OR]=0.999, p=0.0055) and urea (OR=0.991, p=0.0001). Predictors for mortality were: age (OR=0.963, p=0.0001), ferritin (OR=0.999, p=0.0149), glucose (OR=0.993, p=0.0001), urea (OR=0.976, p=0.0001), and creatinine (OR=0.556, p=0.0001). The most reliable laboratory parameters in predicting mortality were: age (area under the curve [AUC]=0.685, p<0.0001), ferritin (AUC=0.610, p<0.05), glucose (AUC=0.681, p<0.0001), urea (AUC=0.856, p<0.0001), and creatinine (AUC=0.823, p<0.0001).

CONCLUSION

High ferritin, glucose, urea, and creatinine levels may predict poor outcomes in COVID-19 patients. These findings could help predict admissions to the ICU and mortality among such patients.

Association of ABO blood types and clinical variables with COVID-19 infection severity in Libya

Objective

The continuing COVID-19 pandemic is a coronavirus-related health emergency (severe acute respiratory syndrome coronavirus 2). Inadequate efforts are still being made to address the illness situation in Libya, and this must change. To address these issues, we looked into the demography and trend of the disease as well as the potential risk factors for infection.

Methods

This study is a retrospective case-control study conducted online among 616 COVID-19 patients. The p_0.05 value, odds ratios, and 95% confidence intervals were calculated and analyzed from the drawn data.

Results

Males were at high risk of COVID-19 than females (odds ratio = 1.3, 95% confidence interval: 1.042-1.622; p = 0.02). Anosmia and ageusia were more prominent in females. Patients with an "AB" blood group are significantly susceptible to infection. Adults (31 and above) are highly liable to infection. The univariate logistic regression analysis revealed that smoking is a risk factor for those above 60 years (odds ratio = 2.228, 95% confidence interval: 1.145-4.336; p = 0.018). Individuals with chronic diseases such as diabetes and/or hypertension are more prone to COVID-19 (odds ratio = 10.045, 95% confidence interval: 3.078-32.794; p = 0.000 and odds ratio = 11.508, 95% confidence interval: 3.930-33.695; p = 0.000, respectively).

Conclusion

This study provided for the first time the demographic data and the trend of COVID-19 infection in Libya, which will assist the stakeholders and governmental bodies in planning protection strategies against the pandemic.

Environmental Stability and Transmissibility of Enveloped Viruses at Varied Animate and Inanimate Interfaces

Enveloped viruses have been the leading causative agents of viral epidemics in the past decade, including the ongoing coronavirus disease 2019 outbreak. In epidemics caused by enveloped viruses, direct contact is a common route of infection, while indirect transmissions through the environment also contribute to the spread of the disease, although their significance remains controversial. Bridging the knowledge gap regarding the influence of interfacial interactions on the persistence of enveloped viruses in the environment reveals the transmission mechanisms when the virus undergoes mutations and prevents excessive disinfection during viral epidemics. Herein, from the perspective of the driving force, partition efficiency, and viral survivability at interfaces, we summarize the viral and environmental characteristics that affect the environmental transmission of viruses. We expect to provide insights for virus detection, environmental surveillance, and disinfection to limit the spread of severe acute respiratory syndrome coronavirus 2.

Reduced susceptibility to COVID-19 associated with ABO blood group and pre-existing anti-A and anti-B antibodies

BACKGROUND

Susceptibility to severe acute respiratory syndrome coronavirus 2 shows individual variability in un-vaccinated and previously un-exposed individuals. We investigated the impact of ABO blood group, titers of anti-A and anti-B, other blood group antigens, and the extracellular deposition of ABH antigens as controlled by secretor fucosyltransferase 2 (FUT2) status.

STUDY DESIGN AND METHODS

We studied incidents in three different hospitals between April to September 2020, where un-diagnosed coronavirus disease 2019 (COVID-19) patients were cared for by health care workers without use of personal protection and with close contact while delivering therapy. We recruited 108 exposed staff, of whom 34 were diagnosed with COVID-19. ABO blood type, titer of anti-A and -B, blood group specific alleles, and secretor status were determined.

RESULTS

Blood group O was associated with lower risk of COVID-19 (OR 0.39, 95 %CI (0.16-0.92), p = 0.03) compared to non-O, i.e., blood groups A, B and AB. High titer anti-A immunoglobulin G (IgG) compared to low titer was associated with lower risk of COVID-19 (OR 0.24 95 %CI (0.07-0.78), p = 0.017). High titer of anti-B immunoglobulin M (IgM) compared to no anti-B (IgM) was associated with lower risk of COVID-19 (OR 0.16, 95 %CI (0.039-0.608), p = 0.006) and the same applies to low titer anti-B (IgM) compared to no titer (OR 0.23, 95 %CI (0.07-0.72), p = 0.012). The 33Pro variant in Integrin beta-3, that is part of human platelet antigen 1b (HPA-1b), was associated with lower risk of COVID-19 (OR 0.23, 95 %CI (0.034-0.86), p = 0.028).

CONCLUSION

Our data showed that blood group O, anti-A (IgG) titer, anti-B (IgM) titer as well as HPA-1b are associated with lower risk for COVID-19.

Long-term hypercoagulability, endotheliopathy and inflammation following acute SARS-CoV-2 infection

INTRODUCTION

both symptomatic and asymptomatic SARS-CoV-2 infections - coined Coronavirus disease 2019 (COVID-19) - have been linked to a higher risk of cardiovascular events after recovery.

AREAS COVERED

our review aims to summarize the latest evidence on the increased thrombotic and cardiovascular risk in recovered COVID-19 patients and to examine the pathophysiological mechanisms underlying the interplay among endothelial dysfunction, inflammatory response and coagulation in long-COVID. We performed a systematic search of studies on hypercoagulability, endothelial dysfunction and inflammation after SARS-CoV-2 infection.

EXPERT OPINION

endothelial dysfunction is a major pathophysiological mechanism responsible for most clinical manifestations in COVID-19. The pathological activation of endothelial cells by a virus infection results in a pro-adhesive and chemokine-secreting phenotype, which in turn promotes the recruitment of circulating leukocytes. Cardiovascular events after COVID-19 appear to be related to persistent immune dysregulation. Patients with long-lasting symptoms display higher amounts of proinflammatory molecules such as tumor necrosis factor-α, interferon γ and interleukins 2 and 6. Immune dysregulation can trigger the activation of the coagulation pathway. The formation of extensive microclots in vivo, both during acute COVID-19 and in long-COVID-19, appears to be a relevant mechanism responsible for persistent symptoms and cardiovascular events.

Universal whole-genome Oxford nanopore sequencing of SARS-CoV-2 using tiled amplicons

We developed a comprehensive multiplexed set of primers adapted for the Oxford Nanopore Rapid Barcoding library kit that allows universal SARS-CoV-2 genome sequencing. This primer set is designed to set up any variants of the primers pool for whole-genome sequencing of SARS-CoV-2 using single- or double-tiled amplicons from 1.2 to 4.8 kb with the Oxford Nanopore. This multiplexed set of primers is also applicable for tasks like targeted SARS-CoV-2 genome sequencing. We proposed here an optimized protocol to synthesize cDNA using Maxima H Minus Reverse Transcriptase with a set of SARS-CoV-2 specific primers, which has high yields of cDNA template for RNA and is capable of long-length cDNA synthesis from a wide range of RNA amounts and quality. The proposed protocol allows whole-genome sequencing of the SARS-CoV-2 virus with tiled amplicons up to 4.8 kb on low-titer virus samples and even where RNA degradation has occurred. This protocol reduces the time and cost from RNA to genome sequence compared to the Midnight multiplex PCR method for SARS-CoV-2 genome sequencing using the Oxford Nanopore.

Association between SUMF1 polymorphisms and COVID-19 severity

BACKGROUND

Evidence shows that genetic factors play important roles in the severity of coronavirus disease 2019 (COVID-19). Sulfatase modifying factor 1 (SUMF1) gene is involved in alveolar damage and systemic inflammatory response. Therefore, we speculate that it may play a key role in COVID-19.

RESULTS

We found that rs794185 was significantly associated with COVID-19 severity in Chinese population, under the additive model after adjusting for gender and age (for C allele = 0.62, 95% CI = 0.44-0.88, P = 0.0073, logistic regression). And this association was consistent with this in European population Genetics Of Mortality In Critical Care (GenOMICC: OR for C allele = 0.94, 95% CI = 0.90-0.98, P = 0.0037). Additionally, we also revealed a remarkable association between rs794185 and the prothrombin activity (PTA) in subjects (P = 0.015, Generalized Linear Model).

CONCLUSIONS

In conclusion, our study for the first time identified that rs794185 in SUMF1 gene was associated with the severity of COVID-19.

Population density and SARS-CoV-2 pandemic: Comparing the geography of different waves in the Netherlands

The COVID-19 pandemic has boosted public and scholarly debate about the relationship between infectious disease and the urban. Cities are considered contagious because they are hubs in (inter)national networks and contain high densities of people. However, the role of the urban and population density in the spread of pathogens is complex and is mediated by the wider bio-social environment. This paper analyses the role of population density in the outbreak of COVID-19 in the densely and highly urbanised context of the Netherlands. It compares the geography of the different phases in the epidemic and assesses when and where density plays a role. Using municipal data on the rate of infections and hospitalisations, this paper reveals that spatial patterns differ substantially in time, which does not appear to be simple diffusion. Using panel regressions, it is demonstrated that population density plays a role in those stages in which containment and mitigation measures were least strict, while in periods of lockdown other factors such as household size are associated with higher infection rates. It concludes that lockdowns may have greater effect in urban areas as key urban elements are temporarily cancelled out.

Epidemiological situation of SARS-CoV-2 infection in Douala, the most populated and highly heterogeneous town of Cameroon: a post-vaccination update

This study aimed at providing an update of SARS-CoV-2 epidemiology in Douala, the most populated and highly heterogeneous town of Cameroon. A hospital-based cross sectional study was conducted from January to September 2022. A questionnaire was used to collect sociodemographic, anthropometric, and clinical data. Retrotranscriptase quantitative polymerase chain reaction was used to detect SARS-CoV-2 in nasopharyngeal samples. Of the 2354 individuals approached, 420 were included. The mean age of patients was 42.3 ± 14.4 years (range 21 - 82). The prevalence of SARS-CoV-2 infection was 8.1%. The risk of infection with SARS-CoV-2 was increased more than seven times in patients aged ≥ 70 years old (aRR = 7.12, p = 0.001), more than six times in married (aRR = 6.60, p = 0.02), more than seven times in those having completed secondary studies (aRR = 7.85, p = 0.02), HIV-positive patients (aRR = 7.64, p < 0.0001) and asthmatic patients (aRR = 7.60, p = 0.003), and more than nine times in those seeking health care regularly (aRR = 9.24, p = 0.001). In contrast, the risk of SARS-CoV-2 infection was reduced by 86% in patients attending Bonassama hospital (aRR = 0.14, p = 0.04), by 93% in patients of blood group B (aRR = 0.07, p = 0.04), and by 95% in COVID-19 vaccinated participants (aRR = 0.05, p = 0.005). There is need for ongoing surveillance of SARS-CoV-2 in Cameroon, given the position and importance of Douala.

Varying Cellular Immune Response against SARS-CoV-2 after the Booster Vaccination: A Cohort Study from Fukushima Vaccination Community Survey, Japan

Booster vaccination reduces the incidence of severe cases and mortality related to COVID-19, with cellular immunity playing an important role. However, little is known about the proportion of the population that has achieved cellular immunity after booster vaccination. Thus, we conducted a Fukushima cohort database and assessed humoral and cellular immunity in 2526 residents and healthcare workers in Fukushima Prefecture in Japan through continuous blood collection every 3 months from September 2021. We identified the proportion of people with induced cellular immunity after booster vaccination using the T-SPOT.COVID test, and analyzed their background characteristics. Among 1089 participants, 64.3% (700/1089) had reactive cellular immunity after booster vaccination. Multivariable analysis revealed the following independent predictors of reactive cellular immunity: age < 40 years (adjusted odds ratio: 1.81; 95% confidence interval: 1.19-2.75; p-value: 0.005) and adverse reactions after vaccination (1.92, 1.19-3.09, 0.007). Notably, despite IgG(S) and neutralizing antibody titers of ≥500 AU/mL, 33.9% (349/1031) and 33.5% (341/1017) of participants, respectively, did not have reactive cellular immunity. In summary, this is the first study to evaluate cellular immunity at the population level after booster vaccination using the T-SPOT.COVID test, albeit with several limitations. Future studies will need to evaluate previously infected subjects and their T-cell subsets.

Blood Type Associated with the Risk of COVID-19 Infection in Pregnant Women

COVID-19 forced us to investigate risk factors to provide the best medical attention, especially in vulnerable groups, such as pregnant patients. Studies in other populations have analyzed blood groups in relation to infection, complications, and death. The present study aimed to analyze the association of blood groups with the risk of infection and complications in pregnant women and newborns from the Mexican-Mestizo population. We studied 1906 individuals. Quantitative variables were analyzed through the Student’s t-test. Categorical variables were analyzed through Pearson’s chi-square test, and logistic regression was used to analyze the association between categorical variables and outcomes. No significant association was observed between blood groups and infection risk. Individuals with the AB blood type are at higher risk for developing severe disease, although blood groups do not seem to be involved in the risk of SARS-CoV-2 infection. However, the AB blood group could be considered a risk factor for developing severe COVID-19 in the Mexican population.

Relationship between the ABO blood group and Rhesus factors with COVID-19 susceptibility

INTRODUCTION

The molecular research has raised copious hypotheses about different molecular effects on the variable expression of the current virus on the human body. The present prospective study aims to determine clinically as well as statistically, the relation between ABO blood groups and Rhesus (Rh) factor and the severity of the Covid-19 virus.

RESEARCH DESIGN AND METHODS

We conducted a prospective, single-centered study at The Combined Military Hospital Lahore, Pakistan. Details of only those patients who exhibit COVID-19 symptoms were included. The odds ratios with a 95% confidence interval and the chi-square test of blood groups and Rhesus factor was also conducted individually with the severity of disease, outcomes, and respiratory symptoms. P-values less than 0.05 was considered significant.

RESULTS

The chi-square test and odd ratio yielded no significant results when the covid-19 status was compared with the Rhesus factor (p-value > 0.05). However, the results were found to be significant when associations were run between Covid-19 status and all the blood groups (p-value < 0.05).

CONCLUSION

According to the analytical results of the present study, protective nature of all the blood antigens (A, B, AB, none) was observed in patients presenting with Covid-19 symptoms of varying severity.

The race to understand immunopathology in COVID-19: Perspectives on the impact of quantitative approaches to understand within-host interactions

The COVID-19 pandemic has revealed the need for the increased integration of modelling and data analysis to public health, experimental, and clinical studies. Throughout the first two years of the pandemic, there has been a concerted effort to improve our understanding of the within-host immune response to the SARS-CoV-2 virus to provide better predictions of COVID-19 severity, treatment and vaccine development questions, and insights into viral evolution and the impacts of variants on immunopathology. Here we provide perspectives on what has been accomplished using quantitative methods, including predictive modelling, population genetics, machine learning, and dimensionality reduction techniques, in the first 26 months of the COVID-19 pandemic approaches, and where we go from here to improve our responses to this and future pandemics.

O-GalNAc glycosylation affects the immunogenicity of the receptor-binding domain (RBD) of SARS-CoV-2 spike protein

The spike protein of SARS-CoV-2 has been widely used as an effective vaccine immunogen, although some limitations still remain. Herein, O-GalNAc glycosylated RBD (Tn-RBD) was synthesized as an antigen via in vitro glycosylation reactions. The inhibition ability against hACE2 binding of antibodies induced with Tn-RBD was 30-40% increased compared to that induced with RBD. This result implies that Tn-glycosylation might play important roles in the immunogenicity of the RBD protein, which should be considered in the design of novel vaccines to fight against COVID-19.

The ultimate tradeoff: how red cell adaptations to malaria alter the host response during critical illness

The human immune system evolved in response to pathogens. Among these pathogens, malaria has proven to be one of the deadliest and has exerted the most potent selective pressures on its target cell, the red blood cell. Red blood cells have recently gained recognition for their immunomodulatory properties, yet how red cell adaptations contribute to the host response during critical illness remains understudied. This review will discuss how adaptations that may have been advantageous for host survival might influence immune responses in modern critical illness. We will highlight the current evidence for divergent host resilience arising from the adaptations to malaria and summarize how understanding evolutionary red cell adaptations to malaria may provide insight into the heterogeneity of the host response to critical illness, perhaps driving future precision medicine approaches to syndromes affecting the critically ill such as sepsis and acute respiratory distress syndrome (ARDS).

Blood-Type-A is a COVID-19 infection and hospitalization risk in a Turkish cohort

We have shown in an ethnically homogenous Turkey cohort with more than six thousand cases and 25 thousand controls that ABO blood types that contain anti-A antibody (O and B) are protective against COVID-19 infection and hospitalization, whereas those without the anti-A antibody (A and AB) are risks. The A + AB frequency increases from 54.7 % in uninfected controls to 57.6 % in COVID-19 outpatients, and to 62.5 % in COVID-19 inpatients. The odds-ratio (OR) for lacking of anti-A antibody risk for infection is 1.16 (95 % confidence interval (CI) 1.1-1.22, and Fisher test p-value 1.8 × 10^-7). The OR for hospitalization is 1.23 (95 %CI 1.06-1.42, Fisher test p-value 0.005). A linear regression treating controls, outpatients, inpatients as three numerical levels over anti-A antibody leads to a p-value of 5.9 × 10^-9. All these associations remain to be statistically significant after conditioning over age, even though age itself is a risk for both infection and hospitalization. We also attempted to correct the potential effect from vaccination, even though vaccination information is not available, by using the date of the data collection as a surrogate to vaccination status. Although no significant association between infection/hospitalization with Rhesus blood system was found, forest plots are used to illustrate possible trends.

COVID-19 is not a causal risk for miscarriage: evidence from a Mendelian randomization study

OBJECTIVE

Coronavirus disease 2019 (COVID-19) has caused a global pandemic in the last three years. The lack of reliable evidence on the risk of miscarriage due to COVID-19 has become a concern for patients and obstetricians. We sought to identify rigorous evidence using two-sample Mendelian randomization (MR) analysis.

METHODS

Seven single-nucleotide polymorphisms (SNPs) associated with COVID-19 were used as instrumental variables to explore causality by two-sample MR. The summary data of genetic variants were obtained from the Genome Wide Association Study (GWAS) among European populations in the UK Biobank and EBI database. Inverse variance weighting (IVW) method was taken as the gold standard for MR results, and other methods were taken as auxiliary. We also performed sensitivity analysis to evaluate the robustness of MR.

RESULTS

The MR analysis showed there was no clear causal association between COVID-19 and miscarriage in the genetic prediction [OR 0.9981 (95% CI, 0.9872-1.0091), p = 0.7336]. Sensitivity analysis suggested that the MR results were robust [horizontal pleiotropy (MR-Egger, intercept = 0.0001592; se = 0.0023; p = 0.9480)].

CONCLUSIONS

The evidence from MR does not support COVID-19 as a causal risk factor for miscarriage in European populations. The small probability of direct placental infection, as well as the inability to stratify the data may explain the results of MR. These findings can be informative for obstetricians when managing women in labor.

ABO Blood Groups and Incidence of COVID-19 in the Mass Gathering Events in Borriana (Spain), March 2020: A Retrospective Cohort Study

Our objective was to estimate the incidence of COVID-19 and the ABO blood Groups in the mass-gathering events (MGEs) during the Falles Festival in Borriana (Spain) from 6-10 March 2020. We conducted a population-based retrospective cohort study and measured anti-SARS-CoV-2 antibodies and the ABO of participants. We performed laboratory COVID-19 tests and obtained the ABO in 775 subjects (72.8% of the original exposed cohort): O-group (45.2%), A-group (43.1%), B-group (8.5%) and AB-group (3.4%). Adjusted for confounding factors, including COVID-19 exposure during the MGEs, attack rates of COVID-19 for each ABO group were 55.4%, 59.6%, 60.2%, and 63.7%. The adjusted relative risks were for O-group 0.93 (95% Confidence Interval [CI] 0.83-1.04), for A-group 1.06 (95% CI 0.94-1.18), for B-group 1.04 (95%CI 0.88-1.24), and for AB-group 1.11 (95% CI 0.81-1.51) with no significant differences. Conclusions: Our results suggest no effect of ABO on COVID-19 incidence. We observed weak but not significant protection of the O-group and not a significantly greater infection risk for the remaining groups compared with the O-group. More studies are needed to resolve the controversies regarding the association between ABO and COVID-19.

Blood pH and COVID-19

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide war. Raising the blood pH might be a crucial strategy to chase COVID-19. The human blood is slightly alkaline, which is essential for cell metabolism, normal physiology, and balanced immunity since all of these biological processes are pH-dependent. Varieties of physiologic derangements occur when the blood pH is disrupted. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) proliferates in acidic blood that magnifies the severity of COVID-19. On the other side, blood acidemia is linked to increased morbidity and mortality because of its complications on immunity, especially in the elderly and in critical diseases such as cancer, musculoskeletal degradation, renal, cardiac, and pulmonary disorders, which result in many pathological disorders such as osteomalacia, and disturbing the hematopoiesis. Additionally, acidemia of the blood facilitates viral infection and progression. Thus, correcting the acid-base balance might be a crucial strategy for the treatment of COVID-19, which might be attributed to the distraction of the viral spike protein to its cognate receptor angiotensin-converting enzyme 2 and supporting the over-taxed immunity.

Exploring the Role of Immune System and Inflammatory Cytokines in SARS-CoV-2 Induced Lung Disease: A Narrative Review

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative pathogen of coronavirus disease 19 (COVID-19). COVID-19 can manifest with a heterogenous spectrum of disease severity, from mild upper airways infection to severe interstitial pneumonia and devastating acute respiratory distress syndrome (ARDS). SARS-CoV-2 infection may induce an over activation of the immune system and the release of high concentrations of pro-inflammatory cytokines, leading to a "cytokine storm", a recognized pathogenetic mechanism in the genesis of SARS-CoV-2-induced lung disease. This overproduction of inflammatory cytokines has been recognized as a poor prognostic factor, since it can lead to disease progression, organ failure, ARDS and death. Moreover, the immune system shows dysregulated activity, particularly through activated macrophages and T-helper cells and in the co-occurrent exhaustion of lymphocytes. We carried out a non-systematic literature review aimed at providing an overview of the current knowledge on the pathologic mechanisms played by the immune system and the inflammation in the genesis of SARS-CoV-2-induced lung disease. An overview on potential treatments for this harmful condition and for contrasting the "cytokine storm" has also been presented. Finally, a look at the experimented experimental vaccines against SARS-CoV-2 has been included.

Effects of ABO blood groups and RH-factor on COVID-19 transmission, course and outcome: A review

ABO and Rh blood grouping systems are two of the non-modifiable risk factors that play an important role in the susceptibility, severity and outcomes of COVID-19 infection. This review explores these associations all over the world, in an attempt to conclude a clear idea for future reference in clinical practice. In the present review, a link has been drawn between blood groups and COVID-19 transmission, course and prognosis, as literature suggests that blood group O plays a protective role against the infection, while blood group A exhibits a higher risk of exacerbation. In contrast with Rh negative individuals, Rh positive individuals are prone to more severe infection and complications, despite the fact that the underlying mechanisms of this association remain understudied. Nevertheless, the connection remains subject to controversy; since some studies report doubts about it. Thus, this association requires further investigation.