Prognostic Factors and Association of Inflammatory Biomarkers with Severity and Mortality in COVID-19

Objectives: To determine prognostic values and association of inflammatory markers with severity and mortality in COVID- 19 in a hospital based study. Study design and setting: This retrospective study was conducted from 1st June 2020 to 30th Sept 2020 in Department of Pathology, Qazi Hussain Ahmed Medical Complex, Nowshera and Medical Teaching Institute, Hayatabad Medical complex Peshawar. Methodology: Out of 215, 71 cases were selected that had all relevant information’s on chart available in Blood bank and department of Pathology. Results: Out of 71 patients, 54 (76.1%) were males and 17 (23.9%) females. Thirty five (49.3%) had age>55 years while 31 (43.7%) were in age range 36-55 years. The frequency of the different blood groups were; 25 (35.2%) B+ blood group followed by 19 (26.8%) A+ and 14 (19.7%) O+ blood group. The AUC for d-dimers was (0.725, 95% CI 0.599-0.855) followed by CRP (0.565 95%CI 0.422-0.7.8) and ferritin (0.519 95%CI 0.36-0.679). The median values of d-dimers was significantly higher in the deceased as compared to the survivors (p<0.05- Mann Whitney U test).The CRP and ferritin levels were not significantly different in study groups. There was a significant positive uphill correlation of the hospital stay with higher values of d-dimers (p=0.01, rs= 0.287). Conclusion: D-dimer is a main prognostic factor that predicts mortality in COVID-19 followed by CRP and serum ferritin levels. Male gender and patient with age>60 are at risk of worst outcome under the impact of deranged values of inflammatory mediators. Hospital stay and blood group of patients have no relation with outcome

Association of Blood Groups with Oral Submucous Fibrosis and if any of the Blood Group is Related with an Increased Risk for Oral Submucous Fibrosis

Objective: To assess any association of blood groups with oral submucous fibrosis and if any of the blood group is related with an increased risk for oral submucous fibrosis. Study Design: Comparative study Place and Duration of Study: Department Of Oral Pathology, Fatima Jinnah Dental College & Hospital Karachi, Pakistan from Jan to Dec 2018. Patients and Methods: Total 100 patients were enrolled in the study in which half were cases where oral sub mucous fibrosis had been diagnosed clinically while remaining half were the controls that were involved in the habit of using tobacco/nuts but had no oral pre malignant lesion. For investigation of blood, samples of blood were taken from both the groups. Odd ration and chi-square test was used to analyze data. A p-value of <0.05 was considered statistically significant. Results: Majority of the individuals in experimental group had “B” blood group followed by “O” “AB” and “A” blood groups. Conclusion: This study showed that ABO blood groups have considerable relation with oral submucous fibrosis. Individuals having “B” blood group had 2.18 times increased tendency of having oral submucous fibrosis in contrast with patients who belong to any other blood group. Keywords: ABO blood group system, Oral Submucous fibrosis, Oral lesions, Oral Squamous Cell Carcinoma

Prevalence of Anti HBC Antibodies in Blood Donors from Different Centers in Lebanon

Background: Hepatitis B virus (HBV) is a major cause of the liver disease that could lead to acute and chronic inflammation of the liver. In this study we collected anti HBC antibodies (anti hepatitis B core) results done as screening of blood donors from three hospital centers in Lebanon between Jan.2016to Jan.2019. The aim of this study is to collect epidemiological data on the prevalence of positive anti HBC antibodies in blood donors of different nationalities. Method: Blood donation records from the three hospitals were collected from Jan. 2016 till Jan. 2019 and they included 16000 volunteers for blood donation and all these donors were tested for anti HBC antibodies. Results: The total number of donors was 16000, 1224 volunteers (7.65%) had positive anti HBC test. The prevalence of anti HBC antibodies was higher in Syrian population with a prevalence of 12.9% as compared to the Lebanese donors with prevalence of 6.6%. Age was found to have a statistically significant relationship with the prevalence of hepatitis B. blood group was found not to have a statistically significant relationship with hepatitis B.

Country-Level Factors Dynamics and ABO/Rh Blood Groups Contribution To COVID-19 Mortality

Identifying factors related to COVID-19 mortality is important to deploy effective containment measures and to safeguard categories at risk. In the last months, several investigations have tried to ascertain essential features for predicting the COVID-19 mortality tolls depending on country-specific dynamics and population structure. Most studies focused on the initial outbreak of COVID-19 spanning the first half of 2020. Several variables, including obesity, health system indicators such as hospital bed density, and bacillus Calmette-Guerin vaccination have been reported as significantly associated to COVID-19 mortality. Here, we examined in different pandemic stages some of the mentioned associations as well as ABO and Rh blood group indicators, which have also been previously linked to COVID-19 severity and fatal outcome. Using a machine learning approach, we found that the “B+” blood group frequency is an important factor at all stages of the pandemic.

Insights from a Pan India Sero-Epidemiological survey (Phenome-India Cohort) for SARS-CoV2

To understand the spread of SARS-CoV2, in August and September 2020, the Council of Scientific and Industrial Research (India), conducted a sero-survey across its constituent laboratories and centers across India. Of 10,427 volunteers, 1058 (10.14%) tested positive for SARS CoV2 anti-nucleocapsid (anti-NC) antibodies; 95% of which had surrogate neutralization activity. Three-fourth of these recalled no symptoms. Repeat serology tests at 3 (n=607) and 6 (n=175) months showed stable anti-NC antibodies but declining neutralization activity. Local sero-positivity was higher in densely populated cities and was inversely correlated with a 30 day change in regional test positivity rates (TPR). Regional seropositivity above 10% was associated with declining TPR. Personal factors associated with higher odds of sero-positivity were high-exposure work (Odds Ratio, 95% CI, p value; 2∙23, 1∙92–2∙59, <0.0001), use of public transport (1∙79, 1∙43–2∙24, <0.0001), not smoking (1∙52, 1∙16–1∙99, 0∙0257), non-vegetarian diet (1∙67, 1∙41–1∙99, <0.0001), and B blood group (1∙36,1∙15-1∙61, 0∙001).

The Probable Association between Blood Groups and Prognosis of COVID-19

Background: We aimed to verify the association between blood group systems and prognosis of SARS-Cov-2 disease. Methods: In this cross-sectional study, 329 patients infected with SARS-Cov-2 diagnosed based on their COVID-19 RT-PCR results and chest CT scans, were enrolled in the study. These patients were admitted to Kamkar Arab Nia Hospital, Qom, Iran from March to June 2020. Their blood groups and RH were determined, and demographic characteristics and clinical signs of patients were recorded. The patients’ temperature and peripheral capillary oxygen saturation levels (SpO2) were measured. Finally, the duration of hospitalization, intubation, and death rate were also analyzed. Results: The results of the patients' blood group analysis were as follows: 129(39.2%) patients had A type, 66(20.1%) B type, 21(6.4%) AB type, and 113(34.3%) O type. Of 329 patients, 297 (90.3%) had Rh antigen. The dead cases were higher in O blood type at 13 cases (11.5%). Considering the positive and negative rhesus antigen, 31 (10.4%) and 1 (3.1%) were dead respectively, but the difference was not statically significant. As for the A group, the mean of admission duration (8.4±6.1 days) was not significantly different from the B group (8.8 ±7.2 days). AB group with a mean (7.4 ±4.4 days) was not significantly different from the O group (7.8 ± 5.4 days). There was no significant difference in the duration of hospitalization in RH patients, positive or negative. B blood group showed a significant association with the time interval to return to normal oxygen levels. Conclusion: Blood type was not associated with COVID-19 death rate, nor was it associated with admission duration. B blood group showed a significant association with the time interval to return to normal oxygen levels.

Why Blood Group A Individuals Are at Risk Whereas Blood Group O Individuals Might Be Protected from SARS-CoV-2 (COVID-19) Infection: A Hypothesis Regarding How the Virus Invades the Human Body via Abo(H) Blood Group-Determining Carbohydrates

While the angiotensin converting enzyme 2 (ACE2) protein is defined as the primary severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor, the viral serine molecule might be mobilized by the host's transmembrane protease serine subtype 2 (TMPRSS2) enzyme from the viral spike (S) protein and hijack the host&rsquo;s N-acetyl-D-galactosamine (GalNAc) metabolism. The resulting hybrid, serologically A-like/Tn (T-nouvelle) structure potentially acts as a host&ndash;pathogen functional molecular bridge. In humans, this intermediate structure will hypothetically be replaced by ABO(H) blood group-specific, mucin-type structures, in the case of infection hybrid epitopes, implicating the phenotypically glycosidic accommodation of plasma proteins. The virus may, by mimicking the synthetic pathways of the ABO(H) blood groups, bind to the cell surfaces of the blood group O(H) by formation of a hybrid H-type antigen as the potential precursor of hybrid non-O blood groups, which does not affect the highly anti-glycan aggressive anti-A and anti-B isoagglutinin activities, exerted by the germline-encoded nonimmune immunoglobulin M (IgM). In the non-O blood groups, which have developed from the H-type antigen, these IgM activities are downregulated by phenotypic glycosylation, while adaptive immunoglobulins might arise in response to the hybrid A and B blood group structures, bonds between autologous carbohydrates and foreign peptides, suggesting the exertion of autoreactivity. The non-O blood groups thus become a preferred target for the virus, whereas blood group O(H) individuals, lacking the A/B phenotype-determining enzymes and binding the virus alone by hybrid H-type antigen formation, have the least molecular contact with the virus and maintain the critical anti-A and anti-B isoagglutinin activities, exerted by the ancestral IgM, which is considered the humoral spearhead of innate immunity.

Why Blood Group A Individuals Are at Risk Whereas Blood Group O Individuals Might Be Protected from SARS-CoV-2 (COVID-19) Infection: A Hypothesis Regarding How the Virus Invades the Human Body via ABO(H) Blood Group-Determining Carbohydrates

While the angiotensin converting enzyme 2 (ACE2) protein is defined as the primary severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor, the viral serine molecule might be mobilized by the host's transmembrane protease serine subtype 2 (TMPRSS2) enzyme from the viral spike (S) protein and hijack the host&rsquo;s N-acetyl-D-galactosamine (GalNAc) metabolism. The resulting hybrid, serologically A-like/Tn (T-nouvelle) structure potentially acts as a host&ndash;pathogen functional molecular bridge. In humans, this intermediate structure will hypothetically be replaced by ABO(H) blood group-specific, mucin-type structures, in the case of infection hybrid epitopes, implicating the phenotypically glycosidic accommodation of plasma proteins. The virus may, by mimicking the synthetic pathways of the ABO(H) blood groups, bind to the cell surfaces of the blood group O(H) by formation of a hybrid H-type antigen as the potential precursor of hybrid non-O blood groups, which does not affect the highly anti-glycan aggressive anti-A and anti-B isoagglutinin activities, exerted by the germline-encoded nonimmune immunoglobulin M (IgM). In the non-O blood groups, which have developed from the H-type antigen, these IgM activities are downregulated by phenotypic glycosylation, while adaptive immunoglobulins might arise in response to the hybrid A and B blood group structures, suggesting the exertion of autoreactivity. The non-O blood groups thus become a preferred target for the virus, whereas blood group O(H) individuals, lacking the A/B phenotype-determining enzymes and binding the virus alone by hybrid H-type antigen formation, have the least molecular contact with the virus and maintain the critical anti-A and anti-B isoagglutinin activities, exerted by the ancestral IgM, which is considered the humoral spearhead of innate immunity.