COVID-19: Blood Type

Biomarker characteristics and blood type - help sharpen the COVID-19 clinical picture

Dicken Weatherby, N.D. and Beth Ellen DiLuglio, MS, RDN, LDN

Blood type was assessed as a factor in susceptibility and severity of COVID-19.

The ODX COVID-19 Series

1. COVID-19: The pandemic that has become endemic
2. COVID-19: Overlapping risk factors and chronic disease
3. Nutritional status COVID-19: A covert factor in disease susceptibility
4. COVID-19: Blood chemistry biomarker patterns - Clues and patterns lurking just under the surface
5. COVID-19: Blood chemistry biomarker patterns - Down the research rabbit hole
6. COVID-19: Blood Biomarkers - Neutrophils
7. COVID-19: Blood Biomarkers - Albumin
8. COVID-19: BloodBiomarkers - Cytokines
9. COVID-19: Blood Biomarkers - Interleukin-6
10. COVID-19: Blood Biomarkers - Interleukin-10
11. COVID-19: Blood Biomarkers - Vitamin C
12. COVID-19: Blood Biomarkers - Vitamin D
13. COVID-19: Blood Biomarkers - Zinc
14. Biomarker characteristics and blood type - help sharpen the COVID-19 clinical picture
15. COVID-19: Initial indications and conventional interventions
16. COVID-19: Long-term risk reduction - Naturopathic, functional medicine, and nutrition-based approaches to prevention
17. A healthy diet is primary prevention for COVID-19
18. You should have a gut feeling about COVID-19
19. Beyond dietary food patterns…plant-based compounds may mitigate COVID-19 risk
20. Targeted nutrition support in the battle against COVID-19
21. Targeted nutrition support in COVID-19: Armed with vitamin C
22. Targeted nutrition support in COVID-19: In sync with zinc
23. Targeted nutrition support in COVID-19: Micronutrients and phytonutrients are important players
24. Optimal Takeaways for improving immunity and reducing susceptibility to COVID-19
25. Optimal - The Podcast: Episode 8 -Blood Biomarkers and Risk Factors for COVID-19 and its Comorbidities

Biomarker clues to COVID-19 severity lie in their specific characteristics:[i]

• Albumin levels correlate with hepatic and renal function and may reflect long-term nutrition status
• Serum albumin of less than 2.9 mg/dL (29 g/L) was the best predictor for ICU admission in a retrospective study of 427 COVID-19 patients. [albumin levels decrease with inflammation]
• Cardiac troponin levels may reveal cardiovascular compromise
• D-dimer may reveal blood clotting dysfunction
• Ferritin and CRP elevations may reflect an increased inflammatory state
• LDH increases may reflect lung damage or widespread tissue damage
• The best cutoffs for predicting mortality from COVID-19 were LDH above 731 U/L (12.2 ukat/L), and an albumin of 1.8 mg/dL (18 g/L) or lower.
• Cutoffs for COVID-19 severity also included a ferritin of greater than 2824 ng/mL (6.3 nmol/L) and CRP greater than 30.3 mg/dL (303 mg/L).
• D-dimer may be useful in patient triage as levels of 1 ug/mL or greater on admission were associated with increased mortality.[ii]

Blood Type and COVID-19

Research suggests that blood type may have an association with testing positive but did not correlate with the severity of COVID-19.[iii] [iv] Blood type did not correlate with intubation or risk of death in those positive with COVID-19.

• Type O blood were less likely to test positive
• Type A blood had no association with testing positive
• Type B and type AB had higher odds of testing positive
• Rh+ status increased odds of testing positive

A prospective study of 164 COVID-19 positive patients with hypertension assessed inflammatory and thrombotic status, and clinical outcomes with regard to blood type: 92 had non-O-type blood and 72 had O-type blood. Results indicated that[v]

• Non-O-type individuals had significantly higher pro-thrombotic indices
• Non-O-type blood was an independent predictor of cardiac injury and death
  • Rates of cardiac injury were significantly higher in the non-O-type blood group (29.3% vs 13.9%).
  • Rates of death were significantly higher in the non-O-blood type group (19.6% vs 8.3%)
• IL-6 levels were independent predictors of cardiac injury and mortality
• D-dimer levels were also independent predictors of mortality

A variety of factors contribute to COVID-19 sequelae. Incorporating these factors into a broad clinical assessment may provide previously overlooked clues to this coronavirus puzzle.

Next Up - COVID-19: Initial indications and conventional interventions

Research

[i] Aloisio, Elena et al. “A comprehensive appraisal of laboratory biochemistry tests as major predictors of COVID-19 severity.” Archives of pathology & laboratory medicine, 10.5858/arpa.2020-0389-SA. 10 Jul. 2020, doi:10.5858/arpa.2020-0389-SA 

[ii] Gallo Marin, Benjamin et al. “Predictors of COVID-19 severity: A literature review.” Reviews in medical virology, e2146. 30 Jul. 2020, doi:10.1002/rmv.2146 

[iii] Latz, Christopher A et al. “Blood type and outcomes in patients with COVID-19.” Annals of hematology vol. 99,9 (2020): 2113-2118. doi:10.1007/s00277-020-04169-1 

[iv] Mendy, Angelico et al. “Is Blood Type Associated with COVID-19 Severity?.” medRxiv : the preprint server for health sciences 2020.08.11.20172676. 14 Aug. 2020, doi:10.1101/2020.08.11.20172676. Preprint. 

[v] Sardu, Celestino et al. “Implications of AB0 blood group in hypertensive patients with covid-19.” BMC cardiovascular disorders vol. 20,1 373. 14 Aug. 2020, doi:10.1186/s12872-020-01658-z