Open Access Journal Article

Relation between ABO and RhD and prevalence and severity of COVID-19 disease

by Ahmed M. Khalaf 1 Marwa O. Elgendy 2,3,* Alzhraa M. Fahmy 4 Sara O. El Gendy 5 Ahmed O. El-Gendy 6 Mona A. Abdelrahman 7 Ali H. El-Bahrawy 8 Ahmed Mohammed M Elsisi 9,10  and  Shafiq Naguib Shafiq 1
Internal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
Department of Clinical Pharmacy, Beni-Suef University Hospitals, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
Department of Clinical Pharmacy, Faculty of Pharmacy, Nahda University (NUB), Egypt
Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
Department of Clinical and Chemical Pathology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
Department of Microbiology and Immunology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
Department of Clinical Pharmacy, Faculty of Pharmacy, Al-Azhar University, Assiut, Egypt
Biochemistry and Molecular Biology Department, Faculty of Pharmacy (Boys), Al-Azhar University, Nasr City, Cairo, Egypt
Biochemistry Department, Faculty of Pharmacy, Sinai University (SU), North Sinai, Al-Arish, Egypt
Author to whom correspondence should be addressed.
IJCMR  2024, 28; 2(3), 28;
Received: 12 February 2024 / Accepted: 5 May 2024 / Published Online: 7 May 2024



This study aims to determine the relation between ABO and RhD and the prevalence and severity of COVID-19 disease.


Data of 495 SARS-CoV-2 infected patients admitted to hospitals were collected. The ABO and RhD were determined for each patient to detect any possible relation between the prevalence of SARS-CoV-2 infection and each blood group. The patients were followed up to determine oxygen saturation and surveillance outcome (died or improved) to detect any possible relation between the severity of COVID-19 disease and each blood group.


A+ blood group was found to have a percentage of 32.3%, O+ to have a percentage of 30.3%, B+ to have a percentage of 21.2%, and AB+ to have a percentage of 10.1%. 19% of all the patients died. 20% of the dead patients were with O+ blood group, 60.5% were with A+ blood group, 10% with B+ blood group and 5% were with O- blood group.

The mean ± SD oxygen saturation on hospital admission was 94.2 ± 6.2% for the patients with O+ blood group, 91.06 ± 7.5% for the patients with A+ blood group, 92.8 ± 6.9% for the patients with B+ blood group, 93.4 ± 3.5% for the patients with AB+ blood group, and 94.5 ± 5.9% for the patients with O- blood group.


Blood group A+ was the most common in the COVID-19 patients followed by O+ then B+ then AB+. Patients with blood group A+ had the worst oxygen saturation at hospital admission and had a higher mortality rate.

Keywords: ;

Copyright: © 2024 by Khalaf, Elgendy, Fahmy, El Gendy, El-Gendy, Abdelrahman, El-Bahrawy, Elsisi and Shafiq. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (Creative Commons Attribution 4.0 International License). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Share and Cite

ACS Style
Khalaf, A. M.; Elgendy, M. O.; Fahmy, A. M.; El Gendy, S. O.; El-Gendy, A. O.; Abdelrahman, M. A.; El-Bahrawy, A. H.; Elsisi, A. M. M.; Shafiq, S. N. Relation between ABO and RhD and prevalence and severity of COVID-19 disease. International Journal of Clinical Medical Research, 2024, 2, 28.
AMA Style
Khalaf A M, Elgendy M O, Fahmy A M, El Gendy S O, El-Gendy A O, Abdelrahman M A, El-Bahrawy A H, Elsisi A M M, Shafiq S N. Relation between ABO and RhD and prevalence and severity of COVID-19 disease. International Journal of Clinical Medical Research; 2024, 2(3):28.
Chicago/Turabian Style
Khalaf, Ahmed M.; Elgendy, Marwa O.; Fahmy, Alzhraa M.; El Gendy, Sara O.; El-Gendy, Ahmed O.; Abdelrahman, Mona A.; El-Bahrawy, Ali H.; Elsisi, Ahmed M. M.; Shafiq, Shafiq N. 2024. "Relation between ABO and RhD and prevalence and severity of COVID-19 disease" International Journal of Clinical Medical Research 2, no.3:28.

Article Metrics

Article Access Statistics


  1. Eid, R.A., M.O. Elgendy, A.M. Sayed, A.M. Abdallah, H.M. Mostafa, A.M.M. Elsisi, A.M. Hamed, and M.A. Shaker, Efficacy of Linezolid in the management of pneumonic COVID-19 patients. Bioinformatics-based clinical study. The Journal of Infection in Developing Countries, 2024. 18(03): p. 326-331.
  2. Alatawi, A.D., M.O. Elgendy, A.M. Sayed, S.N. Shafiq, A.H. El-Bahrawy, T.H. Mallhi, Y.H. Khan, A.I. Alzarea, N.H. Alotaibi, and A.S. Alanazi, Local and Systemic side effects of COVID-19 Vaccines. International Journal of Clinical Medical Research, 2023. 2(1): p. 11-20.
  3. Elgendy, M.O., A.O. El-Gendy, and M.E. Abdelrahim, Public awareness in Egypt about COVID-19 spread in the early phase of the pandemic. Patient education and counseling, 2020. 103(12): p. 2598-2601.
  4. Elgendy, M.O., M.N. Abd Elmawla, A.M. Abdel Hamied, S.O. El Gendy, and M.E. Abdelrahim, COVID‐19 patients and contacted person awareness about home quarantine instructions. International journal of clinical practice, 2020: p. e13810.
  5. Sayed, A.M., A.M. Khalaf, M.E. Abdelrahim, and M.O. Elgendy, Repurposing of some anti‐infective drugs for COVID‐19 treatment: a surveillance study supported by an in silico investigation. International journal of clinical practice, 2020: p. e13877.
  6. Fasina, F.O., Novel coronavirus (2019-nCoV) update: What we know and what is unknown. Asian Pacific Journal of Tropical Medicine, 2020. 13(3): p. 97.
  7. Solmaz, İ. and S. Araç, ABO blood groups in COVID‐19 patients; Cross‐sectional study. International journal of clinical practice, 2020: p. e13927.
  8. Lindesmith, L., C. Moe, S. Marionneau, N. Ruvoen, X. Jiang, L. Lindblad, P. Stewart, J. LePendu, and R. Baric, Human susceptibility and resistance to Norwalk virus infection. Nature medicine, 2003. 9(5): p. 548-553.
  9. Batool, Z., S.H. Durrani, and S. Tariq, Association of ABO and Rh blood group types to hepatitis B, hepatitis C, HIV and Syphillis infection, a five year’experience in healthy blood donors in a tertiary care hospital. Journal of Ayub Medical College Abbottabad, 2017. 29(1): p. 90-92.
  10. Araç, E. and İ. Solmaz, Evaluation of blood groups in patients with anti TPO positive. Asian Journal of Medical Sciences, 2019. 10(6): p. 67-70.
  11. Pelzer, U., F. Klein, M. Bahra, M. Sinn, B. Dörken, P. Neuhaus, O. Meyer, and H. Riess, Blood group determinates incidence for pancreatic cancer in Germany. Frontiers in physiology, 2013. 4: p. 118.
  12. Ray, J.G., M.J. Schull, M.J. Vermeulen, and A.L. Park, Association Between ABO and Rh Blood Groups and SARS-CoV-2 Infection or Severe COVID-19 Illness: A Population-Based Cohort Study. Annals of internal medicine, 2020.
  13. Cheng, Y., G. Cheng, C. Chui, F. Lau, P.K. Chan, M.H. Ng, J.J. Sung, and R.S. Wong, ABO blood group and susceptibility to severe acute respiratory syndrome. Jama, 2005. 293(12): p. 1447-1451.
  14. Majeed, K.R., D. Al-Fahad, H.H. Jalood, H.A. Hantosh, M.K. Ali, S. Sakthivel, H.F. Williams, J.M. Gibbins, K. Patel, and M.F. Baksh, RhD blood type significantly influences susceptibility to contract COVID-19 among a study population in Iraq. F1000Research, 2021. 10(38): p. 38.
  15. Aktimur, S.H., S. Ahmet, B. Yazicioglu, A.K. Gunes, and G. Serhat, The assessment of the relationship between ABO blood groups and Covid-19 infection. International Journal of Hematology and Oncology, 2020. 30(2): p. 001-005.
  16. Göker, H., E.A. Karakulak, H. Demiroğlu, Ç.M.A. Ceylan, Y. Büyükaşik, A.Ç. Inkaya, S. Aksu, N. Sayinalp, I.C. Haznedaroğlu, and Ö. Uzun, The effects of blood group types on the risk of COVID-19 infection and its clinical outcome. Turkish journal of medical sciences, 2020. 50(4): p. 679-683.
  17. Batwa, M.F., Prevalence and prognosis of ABO blood groups among COVID-19 patients at KAUH, Jeddah. MIDDLE EAST JOURNAL OF FAMILY MEDICINE. 7(10): p. 193.
  18. Boren, T., P. Falk, K.A. Roth, G. Larson, and S. Normark, Attachment of Helicobacter pylori to human gastric epithelium mediated by blood group antigens. Science, 1993. 262(5141): p. 1892-1895.
  19. El-Hosari, D.G., W.M. Hussein, M.O. Elgendy, S.O. Elgendy, A.R. Ibrahim, A.M. Fahmy, A. Hassan, F.A. Mokhtar, M.F. Hussein, and M.E. Abdelrahim, Galangal–cinnamon spice mixture blocks the coronavirus infection pathway through inhibition of SARS-CoV-2 MPro, three HCoV-229E targets; quantum-chemical calculations support in vitro evaluation. Pharmaceuticals, 2023. 16(10): p. 1378.
  20. Garg, I., S. Srivastava, V. Dogra, M. Bargotya, S. Bhattar, U. Gupta, S. Jain, J. Hussain, A.A. Hembrom, and N. Ghosh, Potential association of COVID-19 and ABO blood group: An Indian study. Microbial Pathogenesis, 2021: p. 105008.
  21. Torres, A., W.E. Peetermans, G. Viegi, and F. Blasi, Risk factors for community-acquired pneumonia in adults in Europe: a literature review. Thorax, 2013. 68(11): p. 1057-1065.
  22. Elgendy, M.O., H. Saeed, and H.A. Abou-Taleb, Assessment of educated people awareness level and sources about COVID-19. International Journal of Clinical Medical Research, 2023. 1(1): p. 19-27.
  23. Elgendy, M.O., M.A. Abdelrahman, and M.E. Abdelrahim, What should be learned from the COVID-19 pandemic for the next coronavirus pandemics? International Journal of Clinical Medical Research, 2023. 1(1): p. 9-11.
  24. Elgendy, M.O., A.O. El-Gendy, S.O. Elgendy, L.N. Abdelaty, M.E. Abdelrahim, and M.A. Abdelrahman. Perceptions, Knowledge, and Experiences of Using Face Masks among Egyptian Healthcare Workers during the COVID-19 Pandemic: A Cross-Sectional Study. in Healthcare. 2023. MDPI.
  25. Zaki, A., M.O. Elgendy, M.A. Abdelrahman, H. Ali, E.M. Khalil, M. Hassan, A.M. Fahmy, R.A. Gad, and H.F. Salem, The Efficacy of Using Different Antibiotics to Prevent Maternal Surgical Site Infections in COVID-19-Infected Cases. Eur. Chem. Bull, 2023. 6: p. 1342-1348.
  26. Gralinski, L.E., A. Bankhead III, S. Jeng, V.D. Menachery, S. Proll, S.E. Belisle, M. Matzke, B.-J.M. Webb-Robertson, M.L. Luna, and A.K. Shukla, Mechanisms of severe acute respiratory syndrome coronavirus-induced acute lung injury. MBio, 2013. 4(4): p. e00271-13.
  27. Shaban, M., M.O. Elgendy, A.M. Fahmy, D.M. Khalil, A.O. El-Gendy, T.M. Mahmoud, and M.E. Abdelrahim, The Outcomes of COVID-19 Patients with Spontaneous Intracerebral Hemorrhage Comorbidity and the Efficacy of Enoxaparin in Decreasing the Mortality Rate in Them: Single Egyptian Center Report. Journal of Personalized Medicine, 2022. 12(11): p. 1822.
  28. Abdou, L.M., A.O. El-Gendy, M.O. Elgendy, R.A. Gad, S.O. Elgendy, R.A. Eid, A.M. Sayed, and T.M. Mahmoud, The Impact of Combining Cefepime or Ceftazidime with Steroidal and Anticoagulant Therapy in the Treatment of COVID-19 Patients. NeuroQuantology, 2022. 20(15): p. 3696.
  29. Yang, L.-L. and T. Yang, Pulmonary rehabilitation for patients with coronavirus disease 2019 (COVID-19). Chronic diseases and translational medicine, 2020. 6(2): p. 79-86.
  30. Elgendy, S.O., M.O. Elgendy, A.O. El-Gendy, A.M.A. Hamied, K. Al Amir, R.A. Gad, and A.M. Fahmy, Health Care Workers' Awareness about the Post-COVID Syndrome and Different Types of COVID-19 Vaccines in Egypt. NeuroQuantology, 2022. 20(11): p. 3830.
  31. Zhao, J., Y. Yang, H. Huang, D. Li, D. Gu, X. Lu, Z. Zhang, L. Liu, T. Liu, and Y. Liu, Relationship between the ABO Blood Group and the COVID-19 Susceptibility. Clinical Infectious Diseases, 2020.
  32. Elgendy, M.O., M.A. Abdelrahman, H. Osama, A.O. El‐Gendy, and M.E. Abdelrahim, Role of repeating quarantine instructions and healthy practices on COVID‐19 patients and contacted persons to raise their awareness and adherence to quarantine instructions. International Journal of Clinical Practice, 2021. 75(10): p. e14694.
  33. Fahmy, A.M., M.O. Elgendy, A.M. Khalaf, M.A. Abdelrahman, M.E. Abdelrahim, and A.O. El-Gendy, COVID-19 Patients with Hepatic Complications During the Third Wave of Pandemic in Egypt. Journal of Clinical and Nursing Research, 2022. 6(3): p. 108-121.
  34. Elgendy, M.O., A.M. Khalaf, A.O. El-Gendy, M.A. Abdelrahman, S.O. El Gendy, A.M.A. Hamied, O. Essam, K. Al Amir, E.M. Yousry, and M.E. Abdelrahim, An Observational Study on the Management of COVID-19 Patients in Limited-Resource Hospitals. Journal of Clinical and Nursing Research, 2022. 6(3): p. 43-53.
  35. Battistoni, I., M. Francioni, N. Morici, A. Rubboli, G.M. Podda, A. Pappalardo, M.E. Abdelrahim, M.O. Elgendy, S.O. Elgendy, and A.M. Khalaf, Pre-and in-hospital anticoagulation therapy in coronavirus disease 2019 patients: a propensity-matched analysis of in-hospital outcomes. Journal of Cardiovascular Medicine, 2022. 23(4): p. 264-271.
  36. Elgendy, M.O., A.O. El-Gendy, S. Mahmoud, T.Y. Mohammed, M.E. Abdelrahim, and A.M. Sayed, Side effects and efficacy of COVID-19 vaccines among the Egyptian population. Vaccines, 2022. 10(1): p. 109.
  37. Zietz, M., J. Zucker, and N.P. Tatonetti, Testing the association between blood type and COVID-19 infection, intubation, and death. MedRxiv, 2020.
  38. Wu, O., N. Bayoumi, M. Vickers, and P. Clark, ABO (H) blood groups and vascular disease: a systematic review and meta‐analysis. Journal of thrombosis and haemostasis, 2008. 6(1): p. 62-69.
  39. Jenkins, P.V. and J.S. O’Donnell, ABO blood group determines plasma von Willebrand factor levels: a biologic function after all? Transfusion, 2006. 46(10): p. 1836-1844.
  40. Tang, N., D. Li, X. Wang, and Z. Sun, Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia. Journal of thrombosis and haemostasis, 2020. 18(4): p. 844-847.
  41. McGonagle, D., J.S. O'Donnell, K. Sharif, P. Emery, and C. Bridgewood, Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia. The Lancet Rheumatology, 2020.
  42. O’Sullivan, J.M., S. Ward, H. Fogarty, and J.S. O’Donnell, More on ‘Association between ABO blood groups and risk of SARS‐CoV‐2 pneumonia’. British Journal of Haematology, 2020. 190(1): p. 27-28.
  43. Bwire, G.M., Coronavirus: why men are more vulnerable to Covid-19 than women? SN comprehensive clinical medicine, 2020. 2(7): p. 874-876.