Blood Type Does Not Affect Morbidity or Mortality in COVID-19 Infections, As Assessed By a Clinical Severity Scoring System

Introduction:

Coronavirus disease (COVID-19), caused by the novel coronavirus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), continues to lead to worldwide morbidity and mortality. This study aimed to determine if there was an association between blood type and clinical outcomes measured by a calculated morbidity score and mortality rates in patients infected with SARS-CoV-2 at our institution. The secondary aim was to investigate the association between patient characteristics (specifically age, gender, comorbid conditions, and race) and clinical outcomes and mortality in patients with confirmed SARS-COV-2 infection.

Methods:

Logistic regression was used to determine what factors were associated with death. A total morbidity score was constructed based on overall patient's COVID-19 clinical course. This score was modeled using Quasi-Poisson regression. Bayesian variable selection was used for the logistic regression to obtain a posterior probability that blood type is important in predicting worsened clinical outcomes and death.

Results:

Patients with blood type B were more likely to be African American, and patients with blood type AB were less likely to be male. Neither Blood type nor Rh+ status was a significant moderator of death or total morbidity score in regression analyses. Deviance based tests showed that blood type and Rh+ status could be omitted from each regression without a significant decrease in prediction accuracy. Bayesian variable selection showed that the posterior probability that any blood type related covariates were important in predicting death was .10. Increased age (aOR = 3.37, 95% CI = 2.44 - 4.67), male gender (aOR = 1.35, 95% CI = 1.08-1.69), and number of comorbid conditions (aOR = 1.28, 95% CI = 1.01-1.63) were the only covariates that were significantly associated with death. The only significant factors in predicting total morbidity score were age (aOR = 1.45; 95% CI = 1.349-1.555) and gender (aOR = 1.17; 95% CI = 1.109-1.243).

Conclusion:

In a large cohort of COVID-19 positive patients treated at a tertiary care hospital serving a low income population in New Orleans, there is strong evidence that blood type was not a significant predictor of clinical course or death in patients hospitalized with COVID 19. Older age and male gender led to worse clinical outcomes and higher rates of death; whereas older age, male gender, and comorbidities predicted a worse clinical course and higher morbidity score. Race was not a predictor of clinical course or death.