Serra TOPAL, Gülbahar ÇALIŞKAN, Ayça SAYAN, Nermin KELEBEK GİRGİN

COVID-19 Tanılı Klinik ve Yoğun Bakım Hastalarında ABO ve Rh Kan Grup Antijenlerinin Mortalite ile İlişkisi: Bir Pandemi Hastanesi Deneyimi

Giriş ve Amaç: Coronovirus 2019 (COVID-19) tüm dünyada pek çok kişiyi etkileyen ve mortalitesi yüksek olan pandemiye neden olmuştur. ABO kan grupları vasküler, koroner kalp hastalıkları gibi birçok kronik hastalık yanında viral enfeksiyonlarla da ilişkilendirilmektedir.Bu çalışmada kan gruplarının COVID-19’a yatkınlık ve mortalite ile ilşkisini araştırmayı amaçladık. Gereç ve Yöntemler: 17 Mart 2020 ve 30 Kasım 2020 tarihleri arasında PCR pozitif COVID-19 tanısı ile hastanemizde yatırılarak tedavi edilen erişkin hastaların dosyaları retrospektif olarak incelendi. Demografik veriler, ABO ve Rh kan gruplarının dağılım oranları kaydedildi. Kan gruplarının mortaliteye etkisi incelendi. Hastalar serumlarında anti-A bulunması (B ve O kan grubu) ve bulunmamasına (A ve AB kan grubu) göre gruplandırılarak yaş, cinsiyet, yoğun bakıma (YB) yatış ve mortalite açısından karşılaştırıldı. Bulgular: Çalışmaya 3137 hasta dahil edildi. Hastaların 2231’i kliniğe, 906’sı YB’ye yatırılmıştı. Hastalar 55.17±17.90 yaşında olup, %51.2’si erkek idi. Hastaların A, B, AB ve O kan grubuna sahip olma oranları sırasıyla %47.5, %14.5, %8.3 ve %29.6 idi. Hastaların 530’nun tedavisi eksitus ile sonuçlanmıştı. Yaş, klinik ve YB hastalarında mortaliteyi etkilemişti (ikisi için p=0.000). Tüm hastalarda erkek cinsiyette mortalite (%61.9) anlamlı olarak yüksekti (p=0.000). Rh’ın ve serumda anti-A izohemaglütinin bulunmasının mortalite ile ilişkisi yoktu (p=0.42, p=0.565). Multivariate lojistik regresyon analizi sonucu kan grubu mortalite ile ilişkili tespit edilmedi. Yaş, erkek cinsiyet ve mekanik ventilasyon gereksinimi mortalite için bağımsız risk faktörü olarak saptandı (sırasıyla OR.1.073p=<0.001, OR.1.580p=0.001, OR.40.061p<0.001). Sonuç: Çalışmamızda hem klinik hem YB’de takip edilen hastaların ABO kan grubu dağılımlarında fark saptanmadı. Mortalite, AB kan grubunda yüksekti. ABO kan grupları ile SARS-CoV-2 enfeksiyonu arasındaki ilişkinin gösterilmesi için gelecek çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

ABO kan grubu, Rh kan grubu, COVID-19, mortalite

The Relationship of ABO and Rh Blood Group Antigens with Mortality in Clinical and Intensive Care Patients with a Diagnosis of COVID-19: A Pandemic Hospital Experience

Objective: Coronavirus 2019(COVID-19) has caused a pandemic that affects many people all over the world with high mortality.ABO blood groups are associated with many chronic diseases such as vascular and coronary heart diseases,as well as viral infections.In this study,we aimed to investigate the relationship of blood groups with susceptibility to COVID-19 and mortality. Materials and Methods: Between 17 March 2020 and 30 November 2020,the files of adult patients that were hospitalized with the diagnosis of PCR positive COVID-19 in our hospital were reviewed retrospectively.Demographic data,distribution rates of ABO and Rh blood groups were recorded.The effect of blood groups on mortality was analyzed.The patients were grouped according to the presence of anti-A(B and O blood groups)or absence(A and AB blood groups) in their serum and compared in terms of age,gender,intensive care unit(ICU)admission, and mortality. Results: 3137 patients were included in the study.Of the patients,2231 were hospitalized in the wards and 906 in the ICU.The patients were median 57 years old,51.2% of them were male.Most of ICU patients were male gender(p<0.001).The rates of having A,B,AB, and O blood groups of the patients were respectively 47.5%,14.5%,8.3%, and 29.6%.Treatment of 530 patients resulted in death.Age affected mortality in clinical and ICU patients(p= 0.000 for both).While male gender mortality(61.9%) was significantly higher in all patients(p<0.001).The presence of Rh and anti-A isohemagglutinin in the serum was'nt associated with mortality(p=0.42,p= 0.565).As a result of multivariate logistic regression analysis, blood group wasn't found to be associated with mortality. Age, male gender, and need for mechanical ventilation were found to be independent risk factors for mortality(Respectively.1.073 p=<0.001,OR.1.580 p=0.001,OR.40.061p<0.001). Conclusion: In our study,no difference was found in the ABO blood group distributions of the patients followed both clinic and in the ICU.Mortality was higher in the AB blood group.Future studies are needed to show the relationship between ABO blood groups and SARS-CoV-2 infection.

Keywords:

ABO blood group, Rh blood group, COVID-19, mortality,

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