The observed variability in susceptibility to SARS-CoV-2 and severity of the ensuing COVID-19 have raised intense interest in their environmental and genetic risk factors. An early report from China¹ suggested that blood group A was associated with increased susceptibility and blood group O was associated with reduced susceptibility to SARS-CoV-2 infection. These reports motivated widespread interest in examining ABO blood groups as potential COVID-19 risk factors. Subsequent studies from Italy and Spain² reported that blood group A was associated with an increased risk of severe COVID-19 and blood group O was associated with a reduced risk. In contrast, a large Danish study³ implicated disease susceptibility but not severity. However, observations from Boston, Massachussets,⁴ and New York, New York,⁵ did not confirm any specific associations between ABO blood group and disease. The controversy raised by these contrasting reports led to this case-control study.

Claim CME

Buy This Activity

Article Information

Accepted for Publication: March 3, 2021.

Published: April 5, 2021. doi:10.1001/jamanetworkopen.2021.7429

Corresponding Author: Jeffrey L. Anderson, MD, Intermountain Medical Center Heart Institute, 5121 S Cottonwood St, Bldg 4, 6th Floor, Murray, UT 84107 (jeffreyl.anderson@imail.org).

Author Contributions: Dr May and Ms Bair had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Anderson, Muhlestein, Knowlton.

Acquisition, analysis, or interpretation of data: Anderson, May, Knight, Bair, Muhlestein, Horne.

Drafting of the manuscript: Anderson, May, Knight.

Critical revision of the manuscript for important intellectual content: Anderson, Bair, Muhlestein, Knowlton, Horne.

Statistical analysis: May, Knight.

Obtained funding: Anderson.

Administrative, technical, or material support: Anderson, Bair, Muhlestein, Knowlton, Horne.

Supervision: Anderson, Muhlestein, Knowlton, Horne.

Conflict of Interest Disclosures: Dr Muhlestein reported receiving a research endowment from Dell Loy Hansen Heart Foundation Heart Institute during the conduct of the study. Dr Horne reported receiving grants from Intermountain Research and Medical Foundation, AstraZeneca, and PCORnet; nonfinancial support in the form of in-kind donations from GlaxoSmithKline and CareCentra; serving on an advisory board for LabMe.ai; and licensing of intellectual property from Alluceo and CareCentra outside the submitted work. No other disclosures were reported.

Additional Contributions: Brianna Ronnow, MS (Intermountain Healthcare), assisted with manuscript submission and was not compensated for the work.

References

Li J , Wang X , Chen J , Cai Y , Deng A , Yang M . Association between ABO blood groups and risk of SARS-CoV-2 pneumonia. Br J Haematol. 2020;190(1):24-27. doi:10.1111/bjh.16797 PubMed Google Scholar Crossref

Ellinghaus D , Degenhardt F , Bujanda L , et al; Severe Covid-19 GWAS Group. Genomewide association study of severe Covid-19 with respiratory failure. N Engl J Med. 2020;383(16):1522-1534. doi:10.1056/NEJMoa2020283 PubMed Google Scholar Crossref

Barnkob MB , Pottegård A , Støvring H , et al. Reduced prevalence of SARS-CoV-2 infection in ABO blood group O. Blood Adv. 2020;4(20):4990-4993. doi:10.1182/bloodadvances.2020002657 PubMed Google Scholar Crossref

Latz CA , DeCarlo C , Boitano L , et al. Blood type and outcomes in patients with COVID-19. Ann Hematol. 2020;99(9):2113-2118. doi:10.1007/s00277-020-04169-1 PubMed Google Scholar Crossref

Zietz M , Zucker J , Tatonetti NP . Associations between blood type and COVID-19 infection, intubation, and death. Nat Commun. 2020;11(1):5761. doi:10.1038/s41467-020-19623-x PubMed Google Scholar Crossref

Pendu JL , Breiman A , Rocher J , Dion M , Ruvoën-Clouet N . ABO blood types and COVID-19: spurious, anecdotal, or truly important relationships: a reasoned review of available data. Viruses. 2021;13(2):160. doi:10.3390/v13020160 PubMed Google Scholar Crossref

Association of Sociodemographic Factors and Blood Group Type With Risk of COVID-19 in a US Population

See More About

If you are not a JN Learning subscriber, you can either:

A subscription to JN Learning (CME from JAMA Network) provides:

Sign in to access

If you are not a JN Learning subscriber, you can either:

Sign in to customize your interests

With a personal account, you can:

Name Your Search

Sign in to save your search

With a personal account, you can:

Lookup An Activity

My Saved Searches

Sign in to customize your interests

With a personal account, you can:

Purchase access