Effect of ABO blood groups on length of hospital stay according to age in Covid-19 patients

Gursoy, Vildan; Avci, Suna

doi:10.1016/j.htct.2021.08.013

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Hematology, Transfusion and Cell Therapy

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Original article • Hematol., Transfus. Cell Ther. 44 (1) • Jan-Mar 2022 • https://doi.org/10.1016/j.htct.2021.08.013 copy

Effect of ABO blood groups on length of hospital stay according to age in Covid-19 patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Coronavirus Disease 2019 (COVID-19) is a novel viral disease with person-to-person transmission that has spread to many countries since the end of 2019. Although many unknowns were resolved within a year and the vaccine is available, it is still a major global health problem.

Objective

COVID-19 infection may present with a considerably wide spectrum of severity and host factors play a significant role in determining the course of the disease. One of these factors is blood groups. Based on previous experience, it is believed that the ABO blood group type affects prognosis, treatment response and length of stay in the hospital. In this study, our aim was to evaluate whether the blood group had an effect on the length of the hospital stay. To the best of our knowledge, no previous studies have assessed the effect of ABO blood groups, as well as age, on the length of the hospital stay in these settings.

Methods

In this retrospective cohort study, 969 patients admitted to our hospital between March 15, 2020 and May 15, 2020 were evaluated. The patients were divided into 4 groups according to ABO blood groups. The effect of the ABO blood group by age on the course of the disease, need for intensive care, duration of hospitalization and mortality in patients with COVID-19 infection, especially in geriatric patients, was evaluated.

Results

Of all the patients, 9.1% required admission to the intensive care unit (ICU), of whom 83% died. The average length of ICU stay was 11 days (0 - 59). The observed mortality rates in blood groups A, B, AB and 0 were 86.4%, 93.3%, 80.0% and 70.8%, respectively, indicating similar death rates in all ABO blood types. When the Rh phenotype was taken into consideration, no significant changes in results were seen.

Conclusion

As a result, we could not observe a significant relationship between blood groups and clinical outcomes in this study, which included a sample of Turkish patients with COVID-19.

Keywords
Coronavirus disease 2019; ABO blood groups; Geriatric patients; Length of hospital stay

	A (n = 461, 47.5%)	B (n = 145, 15.0%)	0 (n = 279, 28.8%)	AB (n = 84, 8.7%)	TOTAL (n = 969, 100%)
Age- median (min- max)	52 (18 - 92)	49 (20 - 93)	55 (18 - 95)	53 (22 - 93)	53 (18 - 95)
< 65 age	N = 316, 68.5%	N = 101, 69.7%	N = 184, 65.9%	N = 64, 76.2%	N = 665, 68.6%
≥ 65 age	N = 145, 31.5%	N = 44, 30.3%	N = 95, 34.1%	N = 20, 23.8%	N = 304, 31.4%
Gender
Female	N = 240, 52.1%	N = 63, 43.4%	N = 132, 47.3%	N = 41, 48.8%	N = 476, 49.1%
Male	N = 221, 47.9%	N = 82, 56.6%	N = 147, 52.7%	N = 43, 51.2%	N = 493, 50.9%
Comorbidity
Diabetes	N = 101, 21.9%	N = 25, 17.2%	N = 64, 22.9%	N =19, 22.6%	N = 209, 21.6%
Hypertension	N = 195, 42.3%	N = 51, 35.2%	N = 121, 43.5%	N = 44, 52.4%	N = 411, 42.5%
Chronic renal failure	N = 26, 5.6%	N = 7, 4.8%	N = 16, 5.7%	N = 5, 6%	N = 54, 5.6%
Ischemic heart disease	N = 90, 19.5%	N = 18, 12.4%	N = 61, 21.9%	N = 8, 9.5%	N = 177, 18.3%
KOAH	N = 36, 7.8%	N = 11, 7.6%	N = 33, 11.8%	N = 5, 6%	N = 85, 8.8%
Lab Findings at Presentation
White-cell count (x10³ cells/µL)	7 (1 - 47.7) 8.1 ± 4.7	7.7 (1 - 32.6) 8.5 ± 4.6	7 (0.4 - 121.1) 8.9 ± 10.3	6.8 (1.1 - 22.6) 7.8 ± 3.9	7.1 (0.4 - 121.1) 8.4 ± 6.8
Neutrophil count (x10³ cells/µL)	4.2 (0.3 - 41.9) 5.5 ± 4.4	4.7 (0.6 - 31.1) 6.2 ± 4.6	4.3 (0.1 - 32.5) 5.8 ± 4.8	4.2 (0.2 - 19.3) 5.1 ± 3.6	4.3 (0.1 - 41.9) 5.7 ± 4.5
Lymphocyte count (x10³ cells/µL)	1.7 (0.18 - 196) 2.3 ± 9 .2	1.6 (0.06 - 3.7) 1.7 ± 0.82	1.6 (0.22 - 5.5) 1.7 ± 0.87	1.8 (0.24 -4.4) 1.9 ± 0.99	1.7 (0.06 - 196) 2 ± 6.4
Platelet count (x10³ cells/µL)	228 (11 - 1333) 240 ± 97.3	238 (56 - 498) 242 ± 80.6	215 (28 - 779) 232.8 ± 91.8	217 (11.3 - 597) 238.5 ± 86	225 (11 - 1333) 238 ± 92.4
CRP (mg/L)	16.5 (3 - 403) 42.4 ± 58.1	18.8 (3 - 319) 50.2 ± 62	16.4 (3 - 439) 45.5 ± 65	12.1 (3 - 341) 44.1 ± 68.6	16.5 (3 - 439) 44.7 ± 61.7
D- dimer (µg/mL)	0.6 (0.2 - 263) 2.7 ± 14.3	0.7 (0.2 - 24) 2.2 ± 4	0.6 (0.2 - 74) 1.9 ± 5.6	0.6 (0.2 - 30) 2.2 ± 5.1	0.6 (0.2 - 263) 2.3 ± 10.6
Ferritin (ng/mL)	129.3 (4.6 - 16 830) 347.1 ± 1182.2	126.2 (5.6 - 2,000) 278.5 ± 426.6	132 (8 - 3141) 297.1 ± 478	116.3 (9.7 -1744) 266.1 ± 424	128.3 (4.6 - 16,830) 316 ± 885.2
Fibrinojen (mg/dL)	438.5 (44 - 900) 460.7 ± 169.2	447 (140 - 900) 482.4 ± 191.4	437 (48 - 900) 462.7 ± 172.3	411 (228 - 900) 460.1 ± 187.9	438 (44 - 900) 464.5 ± 175
Troponin (pg/mL)	4.7 (3 - 2411) 53.2 ± 217.1	6 (3 - 5,936) 92.7 ± 579.2	6.2 (3 - 983) 34.7 ± 93.2	4.1 (3 - 996) 35.3 ± 120.5	5 (3 - 5936) 52.3 ± 277.6
CK-MB (U/L)	2 (0.4 - 345) 7 ± 33.9	1.8 (0.6 - 25.1) 3 ± 4.5	2.3 (0.3 - 204) 7 ± 26.2	1.7 (0.8 - 22.3) 3.3 ± 5.2	2 (0.3 - 345) 6.2 ± 27.6
Anemia
Yes	N = 209, 46%	N = 62, 43.4%	N = 136, 49.1%	N = 36, 42.9%	N = 443, 46.2%
No	N = 245, 54%	N = 81, 56.6%	N = 141, 50.9%	N = 48, 57.1%	N = 515, 53.8%
Thorax CT involvement
Yes	N = 229, 95.8%	N = 76, 96.2%	N = 138, 97.9%	N = 47, 95.9%	N = 490, 96.5%
No	N = 10, 4.2%	N = 3, 3.8%	N = 3, 2.1%	N = 2, 4.1%	N = 18, 3,5%
Treatments administered
Hydroxychloroquine	N = 456, 99.3%	N = 145, 100%	N = 276, 99.6%	N = 82, 97.6%	N = 965, 99.4%
Oseltamavir	N = 235, 51.9%	N = 64, 44.1%	N = 136, 50%	N = 43, 51.2%	N = 478, 50.1%
Azithromycin	N = 302, 65.8%	N = 90, 62.1%	N = 180, 65.7%	N = 56, 66.7%	N = 628, 65.3%
DMAH	N = 271, 58.8%	N = 97, 66.9%	N = 169, 60.8%	N = 52, 61.9%	N = 589, 60.8%
Favipravir	N = 56, 12.4%	N = 29, 20%	N = 39, 14.2%	N = 10, 12%	N = 134, 14%
Tosilizumab	N = 2, 0.4%	N = 2, 1.4%	N = 2, 0.7%	N = 2, 2.4%	N = 8, 0.8%
Mortality	N = 38, 86.4%	N = 14, 93.3%	N = 17, 70.8%	N = 4, 80%	N = 73, 83%

	A	B	0	AB
Duration of stay (day)	5 (0 - 40) 6.8 ± 5.3	6 (1 - 53) 8.2 ± 7.4	5 (1 - 59) 7.3 ± 6.3	5 (2 - 30) 7.2 ± 5
≤7 days	N = 344, 49.3%	N = 93, 13.3%	N = 203, 29.1%	N = 58, 8.3%
>7 days	N = 117, 43.2%	N = 52, 19.2%	N = 76,28%	N = 26, 9.6%
Age
< 65 y	5 (0 - 32) 6.1 ± 4.2	5 (1 - 22) 7.1 ± 4.7	5 (1 - 27) 6.4 ± 4.3	5 (2 - 23) 6.4 ± 3.8
≥ 65 y	6 (0 - 40) 8.4 ± 6.8	7 (1 - 53) 10.6 ± 11	6 (1 - 59) 9 ± 8.7	6.5 (2 - 30) 9.8 ± 7.2
Gender
Female	5 (0 - 32) 6.5 ± 4.9	5 (2 - 48) 7.6 ± 6.9	5 (1 - 34) 7.1 ± 5.6	5 (2 - 17) 6.2 ± 3.4
Male	5 (0 - 40) 7.2 ± 5.6	6 (1 - 53) 8.6 ± 7.7	5 (1 - 59) 7.5 ± 6.9	5 (2 - 30) 8.1 ± 6.1
Comorbidity
Yes	5 (0 - 40) 7.6 ± 6.3	6.5 (1 - 53) 9.4 ± 9.4	6 (1 - 59) 8 ± 7.2	5 (2 - 23) 7 ± 4.3
No	5 (1 - 26) 6.1 ± 3.8	5 (1 - 30) 7.2 ± 5.2	5 (1 - 34) 6.3 ± 4.9	5 (2 - 30) 7.5 ± 6
PCR
Positive	5 (0 - 40) 7.9 ± 6	8 (2 - 48) 10.1 ± 7.6	6 (1 - 34) 8.5 ± 6.6	6 (2 - 23) 7.9 ± 4.9
Negative	5 (0 - 31) 5.6 ± 4	5 (1 - 53) 6.3 ± 6.7	5 (1 - 59) 6 ± 5.7	5 (2 - 23) 6 ± 3.6
Rh
Positive	5 (0 - 40) 6.8 ± 5.2	6 (1 - 53) 8.3 ± 7.6	5 (1 - 59) 7.4 ± 6.6	5 (2 - 30) 7.1 ± 4.9
Negative	5 (1 - 29) 7.1 ± 5.6	5 (3 - 29) 7.6 ± 6.3	5 (1 - 30) 6.5 ± 4.4	5 (4 - 23) 8 ± 5.7
Anemia
Yes	5 (0 - 40) 7.5 ± 6.2	5 (1 - 48) 8.1 ± 7.7	5 (1 - 59) 7.4 ± 6.9	5 (2 - 30) 7.3 ± 5.4
No	5 (0 - 31) 6.4 ± 4.3	6 (1 - 53) 8.3 ± 7.2	5 (1 - 34) 7.2 ± 5.7	5 (2 - 23) 7.1 ± 4.8

Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular (ABHH) R. Dr. Diogo de Faria, 775 cj 133, 04037-002, São Paulo / SP - Brasil - São Paulo - SP - Brazil
E-mail: htct@abhh.org.br

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[1] *Corresponding author at: Department of Hematology, Usak Education and Training Hospital, University of Usak, Usak, Turkey. E-mail address: vildanterzioglu@hotmail.com (V. Gursoy).