To evaluate the effect of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus on the function and metabolic changes, as well as the relationship of the virus with blood groups.
Methods and Results:
This cross-sectional study included a matched sample of adult individuals with coronavirus disease 2019 (COVID-19) (n = 114) or without (controls; n = 236). Blood samples were collected and processed for triglycerides (TGs), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, and blood typing analysis. The results showed that subjects with COVID-19 had higher TG and lower HDL-C levels compared with the control group. As for blood typing, the risk of COVID-19 was higher in subjects with blood group A than in those with blood group B and in those with other blood groups. In addition, an association of COVID-19 with blood type and Rh A− was observed. When related to the severity of COVID-19 symptoms, blood type A was more protective against moderate/severe symptoms compared with blood type O. In addition, individuals with blood type O were 2.90 times more likely to have symptoms moderate/severe symptoms of COVID-19 than those with other blood groups and individuals with type A blood were less likely to have severe/moderate symptoms of COVID-19 compared with individuals without type A blood.
Conclusion:
The results suggest that blood type may play a role in susceptibility to SARS-CoV-2 infection and add evidence that infection with the novel coronavirus may be associated with changes in lipid metabolism.
Get full access to this article
View all access options for this article.
References
1.
World Health Organization. Coronavirus Disease (COVID-19) Situation Reports. n.d. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports [Last accessed: July31, 2022].
2.
ZhouF, YuT, DuR, et al.Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet, 2020; 395(10229):1054–1062; doi: 10.1016/S0140-6736(20)30566-3
3.
WangD, HuB, HuC, et al.Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA, 2020; 323(11):1061–1069; doi: 10.1001/JAMA.2020.1585
4.
WatanabeM, CarusoD, TuccinardiD, et al.Visceral fat shows the strongest association with the need of intensive care in patients with COVID-19. Metabolism, 2020; 111:154319; doi: 10.1016/J.METABOL.2020.154319
5.
ChanJFW, KokKH, ZhuZ, et al.Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg Microbes Infect, 2020; 9(1):221–236; doi: 10.1080/22221751.2020.1719902
6.
LanJ, GeJ, YuJ, et al.Structure of the SARS-CoV-2 spike receptor-binding domain bound to the ACE2 receptor. Nature, 2020; 581(7807):215–220; doi: 10.1038/S41586-020-2180-5
7.
CoolingL. Blood groups in infection and host susceptibility. Clin Microbiol Rev, 2015; 28(3):801–870; doi: 10.1128/CMR.00109-14
8.
LiuN, ZhangT, MaL, et al.The impact of ABO blood group on COVID-19 infection risk and mortality: A systematic review and meta-analysis. Blood Rev, 2021; 48:100785; doi: 10.1016/J.BLRE.2020.100785
9.
JingW, ZhaoS, LiuJ, et al.ABO blood groups and hepatitis B virus infection: A systematic review and meta-analysis. BMJ Open, 2020; 10(1):034114; doi: 10.1136/BMJOPEN-2019-034114
10.
LiaoY, XueL, GaoJ, et al.ABO blood group-associated susceptibility to norovirus infection: A systematic review and meta-analysis. Infect Genet Evol, 2020; 81:104245; doi: 10.1016/J.MEEGID.2020.104245
11.
ZaidiFZ, ZaidiARZ, AbdullahSM, et al.COVID-19 and the ABO blood group connection. Transfus Apher Sci, 2020; 59(5):102838; doi: 10.1016/J.TRANSCI.2020.102838
12.
FanQ, ZhangW, LiB, et al.Association between ABO blood group system and COVID-19 susceptibility in Wuhan. Front Cell Infect Microbiol, 2020; 10:404; doi: 10.3389/FCIMB.2020.00404
13.
ChengY, ChengG, ChuiCH, et al.ABO blood group and susceptibility to severe acute respiratory syndrome. JAMA, 2005; 293(12):1450–1451; doi: 10.1001/JAMA.293.12.1450-C
14.
GuillonP, ClémentM, SébilleV, et al.Inhibition of the interaction between the SARS-CoV spike protein and its cellular receptor by anti-histo-blood group antibodies. Glycobiology, 2008; 18(12):1085–1093; doi: 10.1093/GLYCOB/CWN093
15.
ZhaoJ, YangY, HuangH, et al.Relationship between the ABO blood group and the coronavirus disease 2019 (COVID-19) susceptibility. Clin Infect Dis, 2021; 73(2):328–331; doi: 10.1093/CID/CIAA1150
16.
WuBB, GuDZ, YuJN, et al.Association between ABO blood groups and COVID-19 infection, severity and demise: A systematic review and meta-analysis. Infect Genet Evol, 2020; 84:104485; doi: 10.1016/J.MEEGID.2020.104485
17.
BruzzoneC, BizkarguenagaM, Gil-RedondoR, et al.SARS-CoV-2 infection dysregulates the metabolomic and lipidomic profiles of serum. iScience, 2020; 23(10):101645; doi: 10.1016/J.ISCI.2020.101645
18.
MasanaL, CorreigE, IbarretxeD, et al.Low HDL and high triglycerides predict COVID-19 severity. Sci Rep, 2021; 11(1):7217; doi: 10.1038/S41598-021-86747-5
19.
MullenPJ, GarciaGJr, PurkayasthaA, et al.SARS-CoV-2 infection rewires host cell metabolism and is potentially susceptible to mTORC1 inhibition. Nat Commun, 2021; 12(1):1876; doi: 10.1038/S41467-021-22166-4
20.
HuX, ChenD, WuL, et al.Low serum cholesterol level among patients with COVID-19 infection in Wenzhou, China [Preprint]. SSRN Electron J, 2020; doi: 10.2139/ssrn.3544826
TanakaS, de TymowskiC, AssadiM, et al.Lipoprotein concentrations over time in the intensive care unit COVID-19 patients: Results from the ApoCOVID study. PLoS One, 2020; 15(9):e0239573; doi: 10.1371/JOURNAL.PONE.0239573
23.
WangG, DengJ, LiJ, et al.The role of high-density lipoprotein in COVID-19. Front Pharmacol, 2021; 12:720283; doi: 10.3389/FPHAR.2021.720283
WeiX, ZengW, SuJ, et al.Hypolipidemia is associated with the severity of COVID-19. J Clin Lipidol, 2020; 14(3):297–304; doi: 10.1016/J.JACL.2020.04.008
26.
WangG, ZhangQ, ZhaoX, et al.Low high-density lipoprotein level is correlated with the severity of COVID-19 patients: An observational study. Lipids Health Dis, 2020; 19(1):204; doi: 10.1186/S12944-020-01382-9
27.
GökerH, Aladağ-KarakulakE, DemiroğluH, et al.The effects of blood group types on the risk of COVID-19 infection and its clinical outcome. Turk J Med Sci, 2020; 50(4):679–683; doi: 10.3906/SAG-2005-395
28.
WuY, FengZ, LiP, et al.Relationship between ABO blood group distribution and clinical characteristics in patients with COVID-19. Clin Chim Acta, 2020; 509:220–223; doi: 10.1016/J.CCA.2020.06.026
29.
KabrahSM, KabrahAM, FlembanAF, et al.Systematic review and meta-analysis of the susceptibility of ABO blood group to COVID-19 infection. Transfus Apher Sci, 2021; 60(4):103169; doi: 10.1016/J.TRANSCI.2021.103169
30.
KhalilA, FeghaliR, HassounM. The lebanese COVID-19 cohort; A challenge for the ABO blood group system. Front Med (Lausanne), 2020; 7:585341; doi: 10.3389/FMED.2020.585341
31.
TakagiH. Down the Rabbit-Hole of blood groups and COVID-19. Br J Haematol, 2020; 190(5):e268–e270; doi: 10.1111/BJH.17059
32.
AbdollahiA, Mahmoudi-AliabadiM, MehrtashV, et al.The novel coronavirus SARS-CoV-2 vulnerability association with ABO/Rh blood types. Iran J Pathol, 2020; 15(3):156–160; doi: 10.3069/9/IJP.2020.125135.2367
33.
BegueF, TanakaS, MouktadiZ, et al.Altered high-density lipoprotein composition and functions during severe COVID-19. Sci Rep, 2021; 11(1):2291; doi: 10.1038/s41598-021-81638-1
34.
BakerJ, AyenewW, QuickH, et al.High-density lipoprotein particles and markers of inflammation and thrombotic activity in patients with untreated HIV infection. J Infect Dis, 2010; 201(2):285–292; doi: 10.1086/649560
35.
CaoWJ, WangTT, GaoYF, et al.Serum lipid metabolic derangement is associated with disease progression during chronic HBV infection. Clin Lab, 2019; 65(12):2377–2386; doi: 10.7754/CLIN.LAB.2019.190525
36.
FanJ, WangH, YeG, et al.Letter to the Editor: Low-density lipoprotein is a potential predictor of poor prognosis in patients with coronavirus disease 2019. Metabolism, 2020; 107:154243; doi: 10.1016/J.METABOL.2020.154243
37.
CaoX, YinR, AlbrechtH, et al.Cholesterol: A new game player accelerating vasculopathy caused by SARS-CoV-2?. Am J Physiol Endocrinol Metab, 2020; 319(1):E197–E202; doi: 10.1152/AJPENDO.00255.2020
38.
AydınS, AksakalE, AydınyılmazF, et al.Relationship between blood lipid levels and mortality in hospitalized COVID-19 patients. Angiology, 2022:73(8):724–733; doi: 10.1177/00033197211072346
39.
FunderburgNT, MehtaNN. Lipid abnormalities and inflammation in HIV inflection. Curr HIV/AIDS Rep, 2016; 13(4):218–225; doi: 10.1007/S11904-016-0321-0
40.
TanakaS, CouretD, Tran-DinhA, et al.High-density lipoproteins during sepsis: From bench to bedside. Crit Care, 2020; 24(1):134; doi: 10.1186/S13054-020-02860-3
41.
ZhuN, ZhangD, WangW, et al.A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med, 2020; 382(8):727–733; doi: 10.1056/NEJMOA2001017
42.
AgouridisAP, PagkaliA, ZintzarasE, et al.High-density lipoprotein cholesterol: A marker of COVID-19 infection severity?. Atheroscler Plus, 2021; 44:1–9; doi: 10.1016/J.ATHPLU.2021.08.007
43.
WendelM, PaulR, HellerAR. Lipoproteins in inflammation and sepsis. II. Clinical aspects. Intensive Care Med, 2007; 33(1):25–35; doi: 10.1007/S00134-006-0433-X
44.
SorokinAV, KarathanasisSK, YangZH, et al.COVID-19-Associated dyslipidemia: Implications for mechanism of impaired resolution and novel therapeutic approaches. FASEB J, 2020; 34(8):9843–9853; doi: 10.1096/FJ.202001451
45.
GrunfeldC, FeingoldKR. The metabolic effects of tumor necrosis factor and other cytokines. Biotherapy, 1991; 3(2):143–158; doi: 10.1007/BF02172087
46.
MeadJR, IrvineSA, RamjiDP. Lipoprotein lipase: Structure, function, regulation, and role in disease. J Mol Med (Berl), 2002; 80(12):753–769; doi: 10.1007/S00109-002-0384-9
47.
Tengku-MuhammadTS, HughesTR, CryerA, et al.Differential regulation of lipoprotein lipase in the macrophage J774.2 cell line by cytokines. Cytokine, 1996; 8(7):525–533; doi: 10.1006/CYTO.1996.0071
48.
Filippas-NtekouanS, LiberopoulosE, ElisafM. Lipid testing in infectious diseases: Possible role in diagnosis and prognosis. Infection, 2017; 45(5):575–588; doi: 10.1007/S15010-017-1022-3
49.
GarrisonRJ, WilsonPW, CastelliWP, et al.Obesity and lipoprotein cholesterol in the Framingham offspring study. Metabolism, 1980; 29(11):1053–1060; doi: 10.1016/0026-0495(80)90216-4
50.
de LusignanS, DorwardJ, CorreaA, et al.Risk factors for SARS-CoV-2 among patients in the Oxford Royal College of General Practitioners Research and Surveillance Centre primary care network: A cross-sectional study. Lancet Infect Dis, 2020; 20(9):1034–1042; doi: 10.1016/S1473-3099(20)30371-6
51.
SimonnetA, ChetbounM, PoissyJ, et al.High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation. Obesity (Silver Spring), 2020; 28(7):1195–1199; doi: 10.1002/OBY.22831
52.
DuY, LvY, ZhaW, et al.Association of body mass index (BMI) with critical COVID-19 and in-hospital mortality: A dose-response meta-analysis. Metabolism, 2021; 117:154373; doi: 10.1016/J.METABOL.2020.154373
53.
HendrenNS, de LemosJA, AyersC, et al.Association of body mass index and age with morbidity and mortality in patients hospitalized with COVID-19: Results from the American Heart Association COVID-19 Cardiovascular Disease Registry. Circulation, 2021; 143(2):135–144; doi: 10.1161/CIRCULATIONAHA.120.051936
54.
AndersonMR, GelerisJ, AndersonDR, et al.Body mass index and risk for intubation or death in SARS-CoV-2 infection: A retrospective cohort study. Ann Intern Med, 2020; 173(10):782–790; doi: 10.7326/M20-3214
55.
TartofSY, QianL, HongV, et al.Obesity and mortality among patients diagnosed with COVID-19: Results from an integrated health care organization. Ann Intern Med, 2020; 173(10):773–781; doi: 10.7326/M20-3742
56.
Mahamat-SalehY, FioletT, RebeaudME, et al.Diabetes, hypertension, body mass index, smoking and COVID-19-related mortality: A systematic review and meta-analysis of observational studies. BMJ Open, 2021; 11(10); doi: 10.1136/BMJOPEN-2021-052777
57.
YangJ, HuJ, ZhuC. Obesity aggravates COVID-19: A systematic review and meta-analysis. J Med Virol, 2021; 93(1):257–261; doi: 10.1002/JMV.26237
58.
KassirR. Risk of COVID-19 for patients with obesity. Obes Rev, 2020; 21(6):13034; doi: 10.1111/OBR.13034
59.
HussainA, MahawarK, XiaZ, et al.Retraction notice to obesity a nd mortality of COVID-19. Meta-analysis [Obesity Research & Clinical Practice 14/4 (2020) 295-300]. Obes Res Clin Pract, 2021; 15(1):100; doi: 10.1016/J.ORCP.2020.12.008
60.
Al-BennaS. Association of high level gene expression of ACE2 in adipose tissue with mortality of COVID-19 infection in obese patients. Obes Med, 2020; 19:100283; doi: 10.1016/J.OBMED.2020.100283
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
