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ABO 和 Rh 血型与 SARS-CoV-2 感染或严重 COVID-19 疾病的关联：一项基于人群的队列研究。

Association Between ABO and Rh Blood Groups and SARS-CoV-2 Infection or Severe COVID-19 Illness : A Population-Based Cohort Study.

机构信息

St. Michael's Hospital, University of Toronto, and ICES, Toronto, Ontario, Canada (J.G.R.).

Sunnybrook Research Institute, University of Toronto, and ICES, Toronto, Ontario, Canada (M.J.S.).

出版信息

Ann Intern Med. 2021 Mar;174(3):308-315. doi: 10.7326/M20-4511. Epub 2020 Nov 24.

DOI:10.7326/M20-4511

PMID:33226859

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7711653/

Abstract

BACKGROUND

The ABO and rhesus (Rh) blood groups may influence risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

OBJECTIVE

To determine whether ABO and Rh blood groups are associated with risk for SARS-CoV-2 infection and severe coronavirus disease 2019 (COVID-19) illness.

DESIGN

Population-based cohort study.

SETTING

Ontario, Canada.

PATIENTS

All adults and children who had ABO blood group assessed between January 2007 and December 2019 and who subsequently had SARS-CoV-2 testing between 15 January and 30 June 2020.

MEASUREMENTS

The main study outcome was SARS-CoV-2 infection, determined by viral RNA polymerase chain reaction testing. A second outcome was severe COVID-19 illness or death. Adjusted relative risks (aRRs) and absolute risk differences (ARDs) were adjusted for demographic characteristics and comorbidities.

RESULTS

A total of 225 556 persons were included, with a mean age of 54 years. The aRR of SARS-CoV-2 infection for O blood group versus A, AB, and B blood groups together was 0.88 (95% CI, 0.84 to 0.92; ARD, -3.9 per 1000 [CI, -5.4 to -2.5]). Rhesus-negative (Rh-) blood type was protective against SARS-CoV-2 infection (aRR, 0.79 [CI, 0.73 to 0.85]; ARD, -6.8 per 1000 [CI, -8.9 to -4.7]), especially for those who were O-negative (O-) (aRR, 0.74 [CI, 0.66 to 0.83]; ARD, -8.2 per 1000 [CI, -10.8 to -5.3]). There was also a lower risk for severe COVID-19 illness or death associated with type O blood group versus all others (aRR, 0.87 [CI, 0.78 to 0.97]; ARD, -0.8 per 1000 [CI, -1.4 to -0.2]) and with Rh- versus Rh-positive (aRR, 0.82 [CI, 0.68 to 0.96]; ARD, -1.1 per 1000 [CI, -2.0 to -0.2]).

LIMITATION

Persons who rapidly died of severe COVID-19 illness may not have had SARS-CoV-2 testing.

CONCLUSION

The O and Rh- blood groups may be associated with a slightly lower risk for SARS-CoV-2 infection and severe COVID-19 illness.

PRIMARY FUNDING SOURCE

Ontario Academic Health Sciences Centre AFP Innovation Fund and the Ontario Ministry of Health and Long-Term Care.

摘要

背景

ABO 和 Rh（恒河猴）血型可能会影响严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的风险。

目的

确定 ABO 和 Rh 血型是否与 SARS-CoV-2 感染和严重 2019 年冠状病毒病（COVID-19）疾病的风险相关。

设计

基于人群的队列研究。

地点

加拿大安大略省。

患者

所有在 2007 年 1 月至 2019 年 12 月期间评估 ABO 血型且随后在 2020 年 1 月 15 日至 6 月 30 日期间接受 SARS-CoV-2 检测的成年人和儿童。

测量

主要研究结果是 SARS-CoV-2 感染，通过病毒 RNA 聚合酶链反应检测确定。第二个结果是严重 COVID-19 疾病或死亡。调整后的相对风险（aRR）和绝对风险差异（ARD）是根据人口统计学特征和合并症进行调整的。

结果

共纳入 225556 人，平均年龄为 54 岁。与 A、AB 和 B 血型组合相比，O 血型感染 SARS-CoV-2 的 aRR 为 0.88（95%CI，0.84 至 0.92；ARD，每 1000 人减少 3.9 例[CI，5.4 至 2.5]）。Rh-（Rh-）血型对 SARS-CoV-2 感染具有保护作用（aRR，0.79[CI，0.73 至 0.85]；ARD，每 1000 人减少 6.8 例[CI，8.9 至 4.7]），尤其是 O-（O-）的人（aRR，0.74[CI，0.66 至 0.83]；ARD，每 1000 人减少 8.2 例[CI，10.8 至 5.3]）。与其他血型相比，O 型血的人患严重 COVID-19 疾病或死亡的风险也较低（aRR，0.87[CI，0.78 至 0.97]；ARD，每 1000 人减少 0.8 例[CI，1.4 至 0.2]），Rh- 与 Rh-（aRR，0.82[CI，0.68 至 0.96]；ARD，每 1000 人减少 1.1 例[CI，2.0 至 0.2]）。