key: cord-0821198-tk2505pi
authors: CHEGNI, Hamid; PAKRAVAN, Nafiseh; SAADATI, Mojtaba; GHAFFARI, Ali Dalir; SHIRZAD, Hadi; HASSAN, Zuhair M
title: Is There a Link between COVID-19 Mortality with Genus, Age, ABO Blood Group Type, and ACE2 Gene Polymorphism?
date: 2020-08-03
journal: Iran J Public Health
DOI: 10.18502/ijph.v49i8.3910
sha: 018201a8884b919d7736fcaf75bd1f66a0d32d6f
doc_id: 821198
cord_uid: tk2505pi

nan

A group of pneumonia patients in Wuhan created an alarm worldwide by the end of December 2019. This emerging pneumonia soon became as a novel coronavirus (2019-nCoV or COVID-19) (1) . More than 80% of individuals with COVID-19 have a "mild illness and will heal" whereas it is lethal in 2% of reported cases (2) . The age and sex of individuals are two risk factors of COVID-19 susceptibility and its clinical outcome (3) . It is therefore highly important to specify briskly the odds ratio for mortality adjusted to comorbidities that are highly prevalent globally, by age and sex, to prevent COVID-19 specific mortality (4) . We aimed to compute the relationship between the ABO blood type, age, sex, and ACE2 gene polymorphism with the susceptibility to COVID-19 in patients from Iran to test if the former can act as a biomarker for the latter. Our study was performed on 94 random samples of dead cases infected with SARS-CoV-2. Of these, only 76 were identified by blood type. A recent survey of ABO blood group distribution of 80,982,137 normal people from Iran was used as comparison controls for patients with COVID-19 (https://en.wikipedia.org/wiki/Blood_type_distr ibution_by_country). Then, statistical analysis was performed using SPSS software version 15 (Chicago, IL, USA). The ABO blood group in 80,982,137 normal people and 76 dead patients with COVID-19 is showed in Table 1 . People with type A phenotype were substantially more likely to become infected with 2019-nCoV (95% CI, P= 0.014, Fig. 1A ). The O, AB and B blood groups seemed to have a lower risk of infection, although the associations did not reach statistical significance (Table 1) . We noticed that ABO blood groups exhibited various association risks for the infection with SARS-CoV-2 resulting in COVID-19. Our results similar to another one (3), in Wuhan, China showed blood group A was significantly associated with a higher risk of infection and blood group O was associated with a lower risk (3). Moreover, we analyzed the people's age and sex as two other risk factors among patients with COVID-19 where the COVID-19 mortality rate for men was four times more than that of women. The genus of dead patients was 73 men and 21 women. These results corresponded to a significantly increased risk of men in comparison with women for COVID-19 (Fig. 1B) (P< 0.001). Also, current survey suggested that patients with ages of 50 < years are at greater risk relative to children who might be less likely to become infected or may show milder signs or even asymptomatic infection (P= 0.004). A dead case with the "age of 94 is also shown in Table 1 and Fig.  1C . "Angiotensin-converting enzyme 2 (ACE2) is an enzyme attached to the outer surface (cell membranes) of cells in the lungs, arteries, heart, kidney, and intestines "(https://en.wikipedia.org/wiki/Angiotensin-converting_enzyme_2). ACE2 is known as SARS-CoV-2 receptor and balance of ACE-ACE2 axis and blood pressure are important in patients with COVID-19 and susceptibility to the disease. Association between genotype of ACE2-ACE axis, blood group A, and blood pressure has been previously reported (5, 6) . Despite the genetic differences between Chinese and Iranian nations in ACE-ACE2 axis (7), people with blood group A in both nations are more susceptible to COVID-19 and risk of death.

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The authors declare that there is no conflict of interests.