J Hematol

Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc

Journal website https://www.thejh.org

Original Article

Volume 10, Number 2, April 2021, pages 64-70

ABO in Correlation to the Requirement of Mechanical Ventilation and Mortality in Critically Ill Patients With COVID-19

Figure 2. Box plots of clinical laboratory results and some serum inflammatory biomarkers. (a) hemoglobin; (b) platelet count; (c) white blood cell count; (d) neutrophil count; (e) lymphocyte count; (f) D-dimer; (g) C-reactive protein; (h) ferritin concentration; (i) lactate dehydrogenase. Sample size was 90 patients split into blood groups O/B and A/AB.

Figure 3. Cumulative hazards of length of stay and blood factors on both mortality and need for intubation. Both risk of mortality and need for intubation increase with the increased length of stay in all blood groups with no significant difference.

**Table 1.** Assessment and Guidance for COVID-19 Patient Critical Care Management
Clinical status	Suggested action
COVID-19: coronavirus disease 2019.
Respiratory rate ≥ 20 bpm with SpO₂ ≤ 94%	Administer O₂ < 40% by face mask, if SpO₂ rises to > 94%, observe and monitor
Respiratory rate ≥ 20 bpm with SpO₂ ≤ 94% on FiO₂ ≥ 40%	Start 15 L/min O₂ via non-rebreathing mask. Senior clinical review to consider: a trial of continuous positive airway pressure, if appropriate mental status and able to tolerate well-fitted non-vented face mask.
Respiratory rate ≥ 20 bpm with SpO₂ ≤ 94% on 15 L/min O₂ via non-rebreathing mask and/or patient unable to tolerate continuous positive airway pressure, obtunded/disoriented, rising FiO₂ needs, significant clinical decline	Urgent critical care review

Table 1. Assessment and Guidance for COVID-19 Patient Critical Care Management

Clinical status

Suggested action

COVID-19: coronavirus disease 2019.

Respiratory rate ≥ 20 bpm with SpO₂ ≤ 94%

Administer O₂ < 40% by face mask, if SpO₂ rises to > 94%, observe and monitor

Respiratory rate ≥ 20 bpm with SpO₂ ≤ 94% on FiO₂ ≥ 40%

Start 15 L/min O₂ via non-rebreathing mask. Senior clinical review to consider: a trial of continuous positive airway pressure, if appropriate mental status and able to tolerate well-fitted non-vented face mask.

Respiratory rate ≥ 20 bpm with SpO₂ ≤ 94% on 15 L/min O₂ via non-rebreathing mask and/or patient unable to tolerate continuous positive airway pressure, obtunded/disoriented, rising FiO₂ needs, significant clinical decline

Urgent critical care review

**Table 2.** Comparison of Blood Group Distributions Between National and Provincial Blood Donor Data and ICU-Admitted Patients With COVID-19
Blood group	Provincial (n =57,396), %	National (n = 35,388), %	ICU sample (n = 90), %	ICU vs. provincial, P value	ICU vs. national, P value
COVID-19: coronavirus disease 2019; ICU: intensive care unit.
O	52%	50.1%	45.6%	0.888	0.898
A	26%	29.7%	22.2%
B	18%	16%	26.7%
AB	4%	4.1%	5.6%

Table 2. Comparison of Blood Group Distributions Between National and Provincial Blood Donor Data and ICU-Admitted Patients With COVID-19

Blood group

Provincial (n =57,396), %

National (n = 35,388), %

ICU sample (n = 90), %

ICU vs. provincial, P value

ICU vs. national, P value

COVID-19: coronavirus disease 2019; ICU: intensive care unit.

52%

50.1%

45.6%

0.888

0.898

26%

29.7%

22.2%

18%

16%

26.7%

4.1%

5.6%

**Table 3.** Baseline Demographic Data and Laboratory Results of Patients
	Blood groups	P-value
*P ≤ 0.05.
Demographic data
Age, mean (SD)	58.91 (13.71)	57.52 (14.17)	0.671
Gender
Male, N (%)	44 (67.7%)	18 (72.0%)	0.693
Female, N (%)	21 (32.3%)	7 (28.0%)
Comorbidities
Diabetic mellitus	35 (53.8%)	17 (68.0%)	0.223
Hypertension	40 (61.5%)	17 (68.0%)	0.569
Dyslipidemia	6 (9.2%)	0 (0.0%)	0.116
Cardiac diseases	13 (20.0%)	5 (20.0%)	1.0
Renal dysfunction	14 (21.5%)	6 (24.0%)	0.801
Pulmonary dysfunction	6 (9.2%)	1 (4.0%)	0.407
Obesity	7 (10.8%)	3 (12.0%)	0.868
Other	21 (32.3%)	8 (32.0%)	0.978
Laboratory results
Hemoglobin, mean (SD)	12.43 (2.88)	12.41 (1.81)	0.975
Platelet count, mean (SD)	250.82 (103.4)	215.88 (70.99)	0.124
White blood cell count, mean (SD)	8.83 (4.84)	8.11 (3.78)	0.507
Neutrophil count, mean (SD)	6.75 (4.65)	6.17 (3.44)	0.571
Lymphocyte count, mean (SD)	1.17 (0.70)	1.22 (0.61)	0.769
D-dimer, mean (SD)	3.10 (6.92)	2.44 (4.85)	0.664
C-reactive protein, mean (SD)	126.10 (80.04)	123.35 (87.71)	0.887
Ferritin, mean (SD)	1,017.14 (867.6)	611.01 (637.04)	0.036*
Lactate dehydrogenase, mean (SD)	487.04 (324.98)	371.18 (147.04)	0.09

Table 3. Baseline Demographic Data and Laboratory Results of Patients

Blood groups

P-value

O/B (N = 65)

A/AB (N = 25)

*P ≤ 0.05.

Demographic data

Age, mean (SD)

58.91 (13.71)

57.52 (14.17)

0.671

Gender

Male, N (%)

44 (67.7%)

18 (72.0%)

0.693

Female, N (%)

21 (32.3%)

7 (28.0%)

Comorbidities

Diabetic mellitus

35 (53.8%)

17 (68.0%)

0.223

Hypertension

40 (61.5%)

17 (68.0%)

0.569

Dyslipidemia

6 (9.2%)

0 (0.0%)

0.116

Cardiac diseases

13 (20.0%)

5 (20.0%)

1.0

Renal dysfunction

14 (21.5%)

6 (24.0%)

0.801

Pulmonary dysfunction

6 (9.2%)

1 (4.0%)

0.407

Obesity

7 (10.8%)

3 (12.0%)

0.868

Other

21 (32.3%)

8 (32.0%)

0.978

Laboratory results

Hemoglobin, mean (SD)

12.43 (2.88)

12.41 (1.81)

0.975

Platelet count, mean (SD)

250.82 (103.4)

215.88 (70.99)

0.124

White blood cell count, mean (SD)

8.83 (4.84)

8.11 (3.78)

0.507

Neutrophil count, mean (SD)

6.75 (4.65)

6.17 (3.44)

0.571

Lymphocyte count, mean (SD)

1.17 (0.70)

1.22 (0.61)

0.769

D-dimer, mean (SD)

3.10 (6.92)

2.44 (4.85)

0.664

C-reactive protein, mean (SD)

126.10 (80.04)

123.35 (87.71)

0.887

Ferritin, mean (SD)

1,017.14 (867.6)

611.01 (637.04)

0.036*

Lactate dehydrogenase, mean (SD)

487.04 (324.98)

371.18 (147.04)

0.09

**Table 4.** Clinical Outcomes Between Groups O/B and Groups A/AB
	Blood groups	Statics
*P ≤ 0.05. SD: standard deviation; ICU: intensive care unit; OR: odds ratio; CI: confidence interval.
Hospital length of stay, mean (SD)	18.46 (15.11)	23.40 (17.13)	0.185	0.00*	-	-	-
ICU length of stay, mean (SD)	12.63 (13.1)	18.20 (15.9)	0.033*	0.00*	-	-	-
Intubation, N (%)	32 (49.2%)	13 (52.0%)	0.055	0.08	1.12	0.44 - 2.8	0.814
Days of intubation, mean (SD)	7.62 (11.18)	8.08 (9.26)	0.854	0.19	-	-	-
End results
Death, N (%)	12 (18.5%)	8 (32.0%)	0.166	0.00*	2.07	0.72 - 5.92	0.1713
Recovery, N (%)	53 (81.5%)	17 (68.0)
APACHE II score, mean (SD)	13.11 (8.65)	14.24 (8.7)	0.580	0.00*	-	-	-
Mortality, mean (SD)	20.12 (17.92)	22.72 (23.36%)	0.574	0.00*	-	-	-

Table 4. Clinical Outcomes Between Groups O/B and Groups A/AB

Blood groups

Statics

O/B

A/AB

Paired correlation, P-value

t-test, P-value

Competing risks regression model (O/B considered control group)

95% CI

P-value

*P ≤ 0.05. SD: standard deviation; ICU: intensive care unit; OR: odds ratio; CI: confidence interval.

Hospital length of stay, mean (SD)

18.46 (15.11)

23.40 (17.13)

0.185

0.00*

ICU length of stay, mean (SD)

12.63 (13.1)

18.20 (15.9)

0.033*

0.00*

Intubation, N (%)

32 (49.2%)

13 (52.0%)

0.055

0.08

1.12

0.44 - 2.8

0.814

Days of intubation, mean (SD)

7.62 (11.18)

8.08 (9.26)

0.854

0.19

End results

Death, N (%)

12 (18.5%)

8 (32.0%)

0.166

0.00*

2.07

0.72 - 5.92

0.1713

Recovery, N (%)

53 (81.5%)

17 (68.0)

APACHE II score, mean (SD)

13.11 (8.65)

14.24 (8.7)

0.580

0.00*

Mortality, mean (SD)

20.12 (17.92)

22.72 (23.36%)

0.574

0.00*