The Possible Relationship Between ABO and Rhesus System Phenotypes and SARS-CoV-2 Infection

Abstract

Background: The relationship between blood Rhesus factor and SARS-CoV-2 viral infection has recently been revealed by several studies; however, the underlying mechanism is still unclear. An intriguing finding was the very low viral infection rate among blood Rhesus-negative people (notably O(I) and Rh-) and the high vulnerability in Rh-positive infected patients. Objectives: The current study aimed to find a possible relationship between Rh blood groups and susceptibility to the SARS-CoV-2 viral infection. Based on the results of the comparison of ABO and Rh blood group phenotypes in uninfected (healthy) and post-infection individuals, we were able to identify SARS-CoV-2 susceptible or resistant phenotypes. Methods: A total of 447 blood samples were examined, including 333 from SARS-CoV-2 post-infection patients and 114 from healthy controls within four months (from January 28, 2021, to April 30, 2021). Results: The distribution of phenotypic categories for Rhesus positive (Rh+) and Rhesus negative (Rh-) individuals in the control and post- infection groups has been demonstrated to be identical. There was no correlation between the Rhesus factor and susceptibility to SARS-CoV-2 virus infection. However, there was a significant correlation between the combination of two variables (the Rh and ABO groups) and SARS-CoV- 2 susceptibility. Particularly, the frequency of the O(I) and Rh- phenotypes was approximately 1.4 times lower in the post-infection period than in controls. In contrast, patients in the post-infection period exhibit the largest prevalence of the A(II)Rh+ phenotypic combination. Conclusions: The SARS-CoV-2 infection susceptibility is low in people with the O(I)Rh- phenotype and high in individuals with the A(II)Rh+ phenotype.