Severe Hemolytic Disease of Newborn Due to Alloimmune Anti-E Antibodies: A Case Report

Hemolytic disease in the newborn (HDN) as a cause of early jaundice is mostly due to Rh (D), ABO incompatibility, and rarely due to other minor blood group incompatibility. We report case of Rh anti-E isoimmunization presenting as significant unconjugated jaundice within the 24 h of life. Baby presented with severe jaundice and anemia on day 1 of life. Baby was treated with intensive phototherapy, double volume exchange transfusion (DVET), and intravenous immunoglobulins. On evaluation, both mother and baby had O positive (Rh) blood group; however, the infant showed evidence of severe hemolysis. Positive direct Coombs test (DCT) and 11 cell antibody panel showed anti-E antibodies. This case highlights the importance of early identification and evaluation of HDN in the absence of Rh(D) and ABO incompatibility and possibility of severe hemolysis in Rh anti-E isoimmunization needing DVET.

Association of ABO and Rh Blood Group in Susceptibility, Severity, and Mortality of Coronavirus Disease 2019: A Hospital-Based Study From Delhi, India

BackgroundABO and Rh blood group systems are associated with many diseases including cancerous, infectious, non-infectious, bacterial and viral diseases. Studies have shown association of blood groups A and O with higher and lower odds for coronavirus disease 2019 positivity, respectively.MethodsThis is a single-center, retrospective study conducted at Sir Ganga Ram Hospital, Delhi. We investigated the association of ABO and Rh blood groups with susceptibility to coronavirus disease 2019 infection, severity of disease, recovery period, and mortality of patients. Patients were enrolled from April 8, 2020 to October 4, 2020. A total of 2,586 real-time PCR (RT-PCR)-confirmed coronavirus disease 2019 (COVID-19) patients were recruited. Data was analyzed using chi-square test, odds ratio, and Mann–Whitney test to determine the association of blood groups.ResultsIn the 2,586 COVID-19-infected patients, the frequencies of A, B, O, and AB were 29.93%, 41.80%, 21.19%, and 7.98%, respectively. Of the patients, 98.07% were Rh positive. Blood group A (odds ratio, 1.53; CI, 1.40–1.66; p < 0.001) and B (odds ratio, 1.15; CI, 1.06–1.24; p < 0.001) is observed to be significantly associated with COVID-19 susceptibility, whereas blood group O (odds ratio, 0.65; CI, 0.59–0.71; p < 0.001) and AB (odds ratio, 0.66; CI, 0.59–0.71; p < 0.001) have low risk of COVID-19 infection.ConclusionA, B, and Rh+ are found to be more susceptible to COVID-19 infection, whereas blood groups O, AB, and Rh− are at a lower risk of COVID-19 infection. No association was found between blood groups and susceptibility to severity of disease and mortality.

ASSOCIATION OF TYPE 2 DIABETES MELLITUS WITH ABO AND RH BLOOD GROUP

Objective: To find out the association of type 2 diabetes mellitus with ABO and Rh blood groups. Study Design: Cross sectional study. Place and Duration of Study: Department of Haematology, Combined Military Hospital Lahore, from Jul to Dec 2020. Methodology: A total 179 patients with type 2 diabetes mellitus and 50 healthy individuals were inducted into the study. Five (5ml) blood from the patients was taken via clean aseptic venipuncture in a tube containing EDTA. HbA1C was generated through automated analyzer Cobas c501 and blood grouping was carried out using tube method by an experienced technician. Results: A total of 179 (77.8%) individuals with diabetes mellitus type 2 and 50 (21.7%) healthy cases were inducted into the study as a control group. A statistically significant difference was observed with blood group B being the most prevalent among them (p=0.001). There was a greater frequency of Rh-negative blood group in patients having diabetes mellitus type 2 as compared to the control group. Conclusion: There is a strong association found between ABO and Rh blood group with diabetes mellitus type 2. Blood group B negative was the most common among the patients having diabetes mellitus type 2. Blood group O positive showed the least association.

History of the Rhesus factor and of neonatal jaundice

The history of icterus and neonatal jaundice has been recorded since the 17th century, when a French midwife first described jaundice (jaune) in twins. In 1940, Alexander Wiener and Karl Landsteiner discovered the Rh blood group, and they investigated the isoimmunization via antigen transfer across the placenta from the fetus. Other blood group systems implicated in isoimmunization were discovered between 1901 and 1965. Between 1940-1960, many studies have focused on the etiology of hemolytic disease of the newborn, on incompatibility in the Rh system, cholestasis, metabolic diseases, inhibitors of breast milk, and the association between prematurity and jaun-dice or extremely nuclear jaundice. It is the merit of AW Liley, in 1963, who described the diagram of the same name based on the level of bilirubin in the amniotic fluid and who performed the first fetal transfusions for fetal anemia. Last decades, non-invasive methods of diagnosis and treatment were described.

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.

SARS-CoV-2 Infection Susceptibility of Pregnant Patients at Term Regarding ABO and Rh Blood Groups: A Cohort Study

Background and Objectives: The susceptibility of pregnant patients at term to SARS-CoV-2 infection regarding the ABO and Rh blood group polymorphism was analyzed in this study. Materials and Methods: In this prospective study, 457 patients admitted for delivery at term in our hospital, between 1 April 2020 and 31 December 2020 were studied. There were 46 positive and 411 SARS-CoV-2 negative patients. Their values for RT-PCR, ABO, and Rh blood group analyses, which were determined upon admittance, were studied. Results: A slightly higher percentage of infected pregnant patients at term belonged to the A blood group compared with the percentage belonging to the other blood groups; this was also true for the healthy control group. For the Rh-negative pregnant patients at term, the odds of being infected with SARS-CoV-2 was OR = 1.22 compared with Rh-positive patients where OR = 1. In our study, the highest risk was found among BIII Rh-negative pregnant patients at term (OR = 3). None of the above differences were statistically significant. Conclusions: No significant difference was found between the percentage of ABO or Rh blood groups in SARS-CoV-2 positive patients when compared with SARS-CoV-2 negative patients (p = 0.562).