INVESTIGATING THE ASSOCIATION BETWEEN BLOOD GROUPS, D-DIMER, AND NEUTROPHIL TO LYMPHOCYTE RATIO IN RELATION TO DISEASE SEVERITY AND OUTCOME: RETROSPECTIVE COHORT STUDY ON COVID-19 PATIENTS

Main Article Content

Sohail khan Raja
Mohammad Ali Arshad Abbasi
Rubina Rafique Shiekh
Tashbih E Batool
Khawaja Faizan Ejaz
Muhammad Ishraf ul Islam
Amna Akbar
Maham Tariq
Sabahat Tasneem
Sarosh Khan Jadoon

Keywords

COVID-19, D-dimer, NLR, ABO blood group system

Abstract

Introduction: chronic obstructive pulmonary disease, asthma and tuberculosis are well known fatal disorders. Corona-virus disease of 2019 (COVID-19) caused worldwide pandemic and it affected lungs and caused deaths more than other causes combined in one year. Research has been focused on different aspects of COVID-19 since it emerged. Blood groups and inflammatory markers are being investigated. The thromboembolism marker D-dimer and other coagulation markers are intensively being studied.


Methodology: We conducted a retrospective cohort study in Azad Jammu Kashmir, Pakistan to explore the relationship between blood groups and neutrophil to lymphocyte ratio (NLR) and D-dimers in relation to disease severity and outcomes.


Results: The blood groups A and B+ve are more affected than other blood groups (58%) and NLR and D-dimer predict disease severity (p<-0.05). D-dimer is associated with blood groups, but NLR is not.


Conclusion: The present study gave good insight into role of blood groups, NLR and D-Dimer values in COVID-19 disease severity and outcomes. We recommend that further studies should be done, and more inflammatory markers must be explored as the present study represents only one area of our country.

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References

1. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet (London, England). 2016 Oct;388(10053):1459–544.
2. Göker H, Aladağ Karakulak E, Demiroğlu H, Ayaz Ceylan ÇM, Büyükaşik Y, Inkaya AÇ, et al. The effects of blood group types on the risk of COVID-19 infection and its clinical outcome. Turkish J Med Sci. 2020 Jun;50(4):679–83.
3. Almadhi MA, Abdulrahman A, Alawadhi A, Rabaan AA, Atkin S, AlQahtani M. The effect of ABO blood group and antibody class on the risk of COVID-19 infection and severity of clinical outcomes. Sci Rep [Internet]. 2021;11(1):5745. Available from: https://doi.org/10.1038/s41598-021-84810-9
4. Dobie G, Abutalib S, Sadifi W, Jahfali M, Alghamdi B, Khormi A, et al. The correlation between severe complications and blood group types in COVID-19 patients; with possible role of T polyagglutination in promoting thrombotic tendencies. AIMS Med Sci [Internet]. 2023;10(1):1–13. Available from: https://www.aimspress.com/article/doi/10.3934/medsci.2023001
5. Latz CA, DeCarlo C, Boitano L, Png CYM, Patell R, Conrad MF, et al. Blood type and outcomes in patients with COVID-19. Ann Hematol [Internet]. 2020;99(9):2113–8. Available from: https://doi.org/10.1007/s00277-020-04169-1
6. Reilly JP, Meyer NJ, Shashaty MGS, Feng R, Lanken PN, Gallop R, et al. ABO blood type a is associated with increased risk of ards in whites following both major trauma and severe sepsis. Chest [Internet]. 2014 Apr 1 [cited 2023 Aug 6];145(4):753–61. Available from: http://journal.chestnet.org/article/S0012369215359444/fulltext
7. Cooling L. Blood Groups in Infection and Host Susceptibility. Clin Microbiol Rev. 2015 Jul;28(3):801–70.
8. Portal AO. CORONAVIRUS IN AZAD KASHMIR [Internet]. Available from: https://www.covid19.ajk.gov.pk/
9. Batool Z, Durrani SH, Tariq S. Association Of Abo And Rh Blood Group Types To Hepatitis B, Hepatitis C, Hiv And Syphilis Infection, A Five Year’ Experience In Healthy Blood Donors In A Tertiary Care Hospital. J Ayub Med Coll Abbottabad. 2017;29(1):90–2.
10. Lindesmith L, Moe C, Marionneau S, Ruvoen N, Jiang X, Lindblad L, et al. Human susceptibility and resistance to Norwalk virus infection. Nat Med. 2003 May;9(5):548–53.
11. Laurys Boudin, Frédéric Janvier, Olivier Bylicki, Fabien Dutasta. ABO blood groups are not associated with risk of acquiring the SARS-CoV-2 infection in young adults. Haematologica [Internet]. 2020 Jul 23;105(12 SE-Letters to the Editor):2841–3. Available from: https://haematologica.org/article/view/9825
12. Hoiland RL, Fergusson NA, Mitra AR, Griesdale DEG, Devine D V, Stukas S, et al. The association of ABO blood group with indices of disease severity and multiorgan dysfunction in COVID-19. Blood Adv [Internet]. 2020 Oct 14;4(20):4981–9. Available from: https://doi.org/10.1182/bloodadvances.2020002623
13. Ray JG, Schull MJ, Vermeulen MJ, Park AL. Association Between ABO and Rh Blood Groups and SARS-CoV-2 Infection or Severe COVID-19 Illness. Ann Intern Med [Internet]. 2020 Nov 24;174(3):308–15. Available from: https://doi.org/10.7326/M20-4511
14. Dahlén T, Li H, Nyberg F, Edgren G. A population-based, retrospective cohort study of the association between ABO blood group and risk of COVID-19. J Intern Med [Internet]. 2023 Mar 1;293(3):398–402. Available from: https://doi.org/10.1111/joim.13588
15. Jawdat D, Hajeer A, Massadeh S, Aljawini N, Abedalthagafi MS, Alaamery M. Correlation between ABO Blood Group Phenotype and the Risk of COVID-19 Infection and Severity of Disease in a Saudi Arabian Cohort. J Epidemiol Glob Health. 2022 Mar;12(1):85–91.
16. Gilmiyarova FN, Kolotyeva NA, Kuzmicheva VI, Gusyakova OA, Borodina IA, Baisheva GM, et al. [Blood group and human diseases (review of literature).]. Klin Lab Diagn. 2020;65(4):216–21.
17. Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang Y-Q, et al. Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal Transduct Target Ther [Internet]. 2020;5(1):33. Available from: https://doi.org/10.1038/s41392-020-0148-4
18. Ray JG, Park AL. SARS-CoV-2 vaccination, ABO blood group and risk of COVID-19: population-based cohort study. BMJ Open. 2022 Jul;12(7):e059944.
19. Zietz M, Zucker J, Tatonetti NP. Associations between blood type and COVID-19 infection, intubation, and death. Nat Commun [Internet]. 2020;11(1):5761. Available from: https://doi.org/10.1038/s41467-020-19623-x
20. Barnkob MB, Pottegård A, Støvring H, Haunstrup TM, Homburg K, Larsen R, et al. Reduced prevalence of SARS-CoV-2 infection in ABO blood group O. Blood Adv. 2020 Oct;4(20):4990–3.
21. Tjendra Y, Al Mana AF, Espejo AP, Akgun Y, Millan NC, Gomez-Fernandez C, et al. Predicting Disease Severity and Outcome in COVID-19 Patients: A Review of Multiple Biomarkers. Arch Pathol Lab Med [Internet]. 2020 Aug 20;144(12):1465–74. Available from: https://doi.org/10.5858/arpa.2020-0471-SA
22. Karki D, Gurung R, Nepali P, Kaphle HP, Subedi B, Adhikari S. Raised D-dimer among Admitted COVID-19 Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc. 2022 Jul;60(251):596–9.
23. Yu H-H, Qin C, Chen M, Wang W, Tian D-S. D-dimer level is associated with the severity of COVID-19. Thromb Res. 2020 Nov;195:219–25.
24. Oualim S, Abdeladim S, Ouarradi A El, Bensahi I, Hafid S, Naitlho A, et al. Elevated levels of D-dimer in patients with COVID-19: prognosis value. Pan Afr Med J. 2020;35(Suppl 2):105.
25. Shah S, Shah K, Patel SB, Patel FS, Osman M, Velagapudi P, et al. Elevated D-Dimer Levels Are Associated With Increased Risk of Mortality in Coronavirus Disease 2019: A Systematic Review and Meta-Analysis. Cardiol Rev. 2020;28(6):295–302.
26. Townsend L, Fogarty H, Dyer A, Martin-Loeches I, Bannan C, Nadarajan P, et al. Prolonged elevation of D-dimer levels in convalescent COVID-19 patients is independent of the acute phase response. J Thromb Haemost. 2021 Apr;19(4):1064–70.
27. Lehmann A, Prosch H, Zehetmayer S, Gysan MR, Bernitzky D, Vonbank K, et al. Impact of persistent D-dimer elevation following recovery from COVID-19. PLoS One. 2021;16(10):e0258351.
28. Conte G, Cei M, Evangelista I, Colombo A, Vitale J, Mazzone A, et al. The Meaning of D-Dimer value in Covid-19. Vol. 27, Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. United States; 2021. p. 10760296211017668.

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