Frontiers in Microbiology (Jan 2022)

ABO Blood Group Incompatibility Protects Against SARS-CoV-2 Transmission

  • Rachida Boukhari,
  • Adrien Breiman,
  • Adrien Breiman,
  • Jennifer Jazat,
  • Nathalie Ruvoën-Clouet,
  • Nathalie Ruvoën-Clouet,
  • Salima Martinez,
  • Anne Damais-Cepitelli,
  • Catherine Le Niger,
  • Isabelle Devie-Hubert,
  • Fanny Penasse,
  • Dominique Mauriere,
  • Véronique Sébille,
  • Véronique Sébille,
  • Antoine Dürrbach,
  • Jacques Le Pendu

DOI
https://doi.org/10.3389/fmicb.2021.799519
Journal volume & issue
Vol. 12

Abstract

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ABO blood groups appear to be associated with the risk of SARS-CoV-2 infection, but the underlying mechanisms and their real importance remain unclear. Two hypotheses have been proposed: ABO compatibility-dependence (neutralization by anti-ABO antibodies) and ABO-dependent intrinsic susceptibility (spike protein attachment to histo-blood group glycans). We tested the first hypothesis through an anonymous questionnaire addressed to hospital staff members. We estimated symptomatic secondary attack rates (SAR) for 333 index cases according to spouse ABO blood group compatibility. Incompatibility was associated with a lower SAR (28% vs. 47%; OR 0.43, 95% CI 0.27–0.69), but no ABO dependence was detected in compatible situations. For the second hypothesis, we detected no binding of recombinant SARS-CoV-2 RBD to blood group-containing glycans. Thus, although no intrinsic differences in susceptibility according to ABO blood type were detected, ABO incompatibility strongly decreased the risk of COVID-19 transmission, suggesting that anti-ABO antibodies contribute to virus neutralization.

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