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

Figures

Figure 1.
Figure 1. Distribution of blood groups.
Figure 2.
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.
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.

Tables

Table 1. Assessment and Guidance for COVID-19 Patient Critical Care Management
 
Clinical statusSuggested 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 declineUrgent 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 groupProvincial (n =57,396), %National (n = 35,388), %ICU sample (n = 90), %ICU vs. provincial, P valueICU vs. national, P value
COVID-19: coronavirus disease 2019; ICU: intensive care unit.
O52%50.1%45.6%0.8880.898
A26%29.7%22.2%
B18%16%26.7%
AB4%4.1%5.6%

 

Table 3. Baseline Demographic Data and Laboratory Results of Patients
 
Blood groupsP-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 mellitus35 (53.8%)17 (68.0%)0.223
    Hypertension40 (61.5%)17 (68.0%)0.569
    Dyslipidemia6 (9.2%)0 (0.0%)0.116
    Cardiac diseases13 (20.0%)5 (20.0%)1.0
    Renal dysfunction14 (21.5%)6 (24.0%)0.801
    Pulmonary dysfunction6 (9.2%)1 (4.0%)0.407
    Obesity7 (10.8%)3 (12.0%)0.868
    Other21 (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 groupsStatics
O/BA/ABPaired correlation, P-valuet-test, P-valueCompeting risks regression model (O/B considered control group)
OR95% CIP-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)0.1850.00*---
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%)0.0550.081.120.44 - 2.80.814
Days of intubation, mean (SD)7.62 (11.18)8.08 (9.26)0.8540.19---
End results
Death, N (%)12 (18.5%)8 (32.0%)0.1660.00*2.070.72 - 5.920.1713
Recovery, N (%)53 (81.5%)17 (68.0)
APACHE II score, mean (SD)13.11 (8.65)14.24 (8.7)0.5800.00*---
Mortality, mean (SD)20.12 (17.92)22.72 (23.36%)0.5740.00*---